Background: The diagnosis of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) remains a constraint for some populations in sub-Saharan Africa. This study aimed to determine the ...Background: The diagnosis of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) remains a constraint for some populations in sub-Saharan Africa. This study aimed to determine the prevalence of HBV and HCV in people living with HIV and to evaluate the performance of a combined rapid test for the simultaneous detection of HIV, HBV, and HCV. Methods: This is a cross-sectional study that took place from February 2017 to November 2018 and included 139 HIV-infected individuals followed up at different medical centers in Ouagadougou, Burkina Faso. HBV and HCV serology tests were performed on-site using finger prick whole blood with HIV/HCV/HBsAg combined rapid test and then serum with two reference tests “Architect HBsAg Qualitative” and “Architect HIV Ag/Ab Combo”. Results: The mean age of the participants was 57 ± 8 years. Of the 139 participants, 10% (14/139) were HIV-1 positive, 71.9% (100/139) were HIV-2 positive, and 18.0% (25/139) were HIV-1/HIV-2 coinfected. The sensitivity and specificity of the HIV/HCV/HBsAg combined rapid test were 33.33% vs 99.11% and 20% vs 99.25% compared to Architect HBsAg Qualitative and Architect HIV Ag/Ab Combo, respectively. The Kappa and Youden Index values were 0.4262 and 0.3244 and 0.2707 and 0.1925, respectively, compared to each of the two reference tests. Conclusion: The results show that the HIV/HCV/HBsAg combined rapid test has poor diagnostic efficiency and should not be recommended for the diagnosis of these viruses.展开更多
Human immunodeficiency virus (HIV) is the infectious agent causing acquired immu-nodeficiency syndrome (AIDS),a deadliest scourge of human society. Hepatitis C virus (HCV) is a major causative agent of chronic liver d...Human immunodeficiency virus (HIV) is the infectious agent causing acquired immu-nodeficiency syndrome (AIDS),a deadliest scourge of human society. Hepatitis C virus (HCV) is a major causative agent of chronic liver disease and infects an estimated 170 million people worldwide,resulting in a serious public health burden. Due to shared routes of transmission,co-infection with HIV and HCV has become common among individuals who had high risks of blood exposures. Among hemophiliacs the co-infection rate accounts for 85%; while among injection drug users (IDU) the rate can be as high as 90%. HIV can accelerate the progression of HCV-related liver disease,particularly when immunodeficiency has developed. Although the effect of HCV on HIV infection is controversial,most studies showed an increase in mortality due to liver disease. HCV may act as a direct cofactor to fasten the progression of AIDS and decrease the tolerance of highly active antiretroviral therapy (HARRT). Conversely,HAART-related hepatotoxicity may enhance the progression of liver fibrosis. Due to above complications,co-infection with HCV and HIV-1 has imposed a critical challenge in the management of these patients. In this review,we focus on the epidemiology and transmission of HIV and HCV,the impact of the two viruses on each other,and their treatment.展开更多
Background: Previous research has suggested an association between infection with hepatitis C virus (HCV) or with human immunodeficiency virus (HIV) and low platelet counts. This study estimates platelet count changes...Background: Previous research has suggested an association between infection with hepatitis C virus (HCV) or with human immunodeficiency virus (HIV) and low platelet counts. This study estimates platelet count changes over time in HIV/HCV co-infected participants and compares them with the changes in platelet count among HIV mono-infected participants to test if HIV/HCV co-infection is associated with lower platelet counts. Methods: This retrospective cohort study included all HIV treatment naive patients from four sites in the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort with platelet count measurements between 2002 and 2009. We conducted a mixed effects linear regression modeling the mean change in platelet count per year while adjusting for age, sex, race, baseline CD4 cell count, and site. Index date was the first platelet count after 2002, and participants were censored upon initiation of treatment for HIV or HCV. Results: There were 929 HIV/HCV co-infected and 3558 HIV mono-infected participants with a mean follow-up time of 1.2 years. HIV/HCV co-infected participants had on average a slighter lower platelet count at baseline (234,040 vs. 242,780/μL;p-value = 0.004), and a more rapid mean reduction per year (7230 vs. 3580/μL;p-value 0.001) after adjusting for age, sex, baseline CD4 count. Conclusions: In treatment naive participants, HIV/HCV co-infection is associated with a more rapid decline in platelet count compared with HIV mono-infection.展开更多
BACKGROUND:Co-infection of hepatitis C virus (HCV) and human immunodeficiency virus type 1 ( HIV-1 ) is common in hemophiliacs and drug abusers. To assess the interaction between HIV and HCV disease progression, we ex...BACKGROUND:Co-infection of hepatitis C virus (HCV) and human immunodeficiency virus type 1 ( HIV-1 ) is common in hemophiliacs and drug abusers. To assess the interaction between HIV and HCV disease progression, we examined 82 HIV/HCV co-infection patients and 62 HCV infection patients. METHODS: Liver function, pathological changes, infec- tion duration, immune function and qualitative HCV-RNA and HCV antibody were compared retrospectively between the two groups of patients. RESULTS: Fourty-eight patients (58.5%) in the HIV/ HCV co-infection group and 53 patients (85.5%) in the HCV infection group showed abnormal liver function. No significant difference was observed in inflammation and fi- brosis in the two groups P =0.187, 0.954). However, liver abnormality in the patients with HIV/HCV co-infection appeared 8 years earlier than in those with HCV infection alone (P<0.001). As to immune function, the counts of CD4+T and CD8+ T in the HIV/HCV group were (226.35 ± 173.49)×106/L and (914. 40 ±448. 28)×106/L, whereas in the HCV group they were (752.31±251.69)×l06/L and (529.011170.67)×106/L respectively. The difference in the two groups was highly significant (P<0.001; P<0.001). The ratio of the number of people with both HCV-RNA and HCV antibody positive to the number of HCV-RNA positive and HCV antibody negative in the HIV/HCV group was 52:9, whereas in the HCV group it was 44:1 (P = 0.043). CONCLUSION: HIV/HCV co-infection can accelerate de- terioration of hepatitis C, which may be due to the effect of HIV on cellular immunity and humoral immunity of the body.展开更多
Presence of the hepatitis C virus in HIV infected patients has an additional neurotoxic influence on the Central Nervous System. It has been described that HCV co-infection leads to neuropsychological impairment whose...Presence of the hepatitis C virus in HIV infected patients has an additional neurotoxic influence on the Central Nervous System. It has been described that HCV co-infection leads to neuropsychological impairment whose severity is greater than in mono-HIV infected subjects. In the present study we assessed the neuropsychological status of 46 human immunodeficiency virus (HIV)-infected individuals from the Warsaw Hospital for Infectious Diseases. For the purpose of cognitive assessment, neuropsychological tests measuring global cognitive functions, attention and perception, verbal memory, as well as non-verbal aspects of executive functions, e.g. visual monitoring and planning, were assessed. In 60% of the investigated patients, who were co-infected with the hepatitis C virus, the overall cognitive outcome observed was worse than in mono-HIV infected subjects. The following factors were taken into account: ART therapy’s influence on cognitive functions using the CPE rank (CNS Penetration Efficacy, 2010), route of HIV transmission, conditions of human existence and age of investigated patients. The present work should be treated as a preliminary research and interpreted in the context of several limitations described in the text.展开更多
About 50% of people living with the HIV infection in Italy are co-infected with HCV. In this group of patients, the primary cause of mortality is liver disease, which accounts for up to 14% of deaths. HIV/HCV co-infec...About 50% of people living with the HIV infection in Italy are co-infected with HCV. In this group of patients, the primary cause of mortality is liver disease, which accounts for up to 14% of deaths. HIV/HCV co-infection also exposes patients to a higher risk of progression to AIDS, a faster evolution towards cirrhosis, more frequent drug toxicity, and lower tolerance for antiretroviral therapy. Moreover, HCV infection can play a part in increasing immune system depression;neurological, cognitive and renal damage;and bone fragility. Hence an optimal antiretroviral regimen needs to be chosen for co-administration with anti-HCV therapy and timed appropriately to improve the prognosis of co-infected HIV/HCV patients. Unfortunately, however, data on the safety and efficacy of antiretroviral drugs in these patients is scarce, as are studies of pharmacokinetics in patients with advanced liver impairment. Furthermore, restoring adequate immune constitution seems not to slow the progression of liver disease, and the metabolic and hepatic toxicity of some antiretroviral drugs can even contribute to inflammatory and fibrogenic processes. It is therefore essential that HIV/HCV co-infected patients receive only medications capable of ensuring the best immune recovery but possessing the lowest potential to trigger immune reconstitution syndrome or hepatic and metabolic damage.展开更多
Hepatitis C infection in people living with Human Immunodeficiency Virus (HIV) poses management challenges. Of the world’s population, 3% are estimated to have chronic Hepatitis C Virus (HCV) infection, which is resp...Hepatitis C infection in people living with Human Immunodeficiency Virus (HIV) poses management challenges. Of the world’s population, 3% are estimated to have chronic Hepatitis C Virus (HCV) infection, which is responsible for about 70% of cases of chronic hepatitis (accelerated chronicity in the presence of HIV and for such major complications as cirrhosis and hepatocellular carcinoma. The fibrosis 4 (FIB-4) and Aspartate aminotransferase/platelet ratio index (APRI) scores are simple, inexpensive tests accessible to most people, and their performance has not yet been studied in C?te d’Ivoire. Objective: To prospectively evaluate the diagnostic performance of APRI and FIB-4 scores in liver damage in those co-infected with HIV/HCV in C?te d’Ivoire. Methods: This study was conducted over three months. The patients came from national blood transfusion center of the cities of Man and Daloa. The criteria for selecting respondents were at least 18 years of age and a positive test for HIV and HCV. APRI and FIB-4 scores were calculated for each patient from biological data obtained by COBAS C311 (Roche Hitachi, Japan). Statistical analyses were performed using GraphPad and MED-CALC software. Results: Our study involved 30 patients (men) of middle age (25 - 52 years), with extremes ranging from 0.67 to 8 for APRI and 0.201 to 22 for FIB-4. A predictive APRI and FIB4 score of significant hepatic fibrosis was observed in 23% of patients;however, 46% and 54% of patients for the APRI and FIB-4 score, respectively, would not have significant fibrosis. An APRI and FIB4 score not included in the classification limits of the type of fibrosis hepatitis was observed in 31% and 23% of patients, respectively. Conclusion: The performance of the APRI and FIB-4 biological scores analyzed according to the interpretation of their cut-off values would enable classifying about 70% and 77%, respectively, of the patient population in the stages of hepatitis C fibrosis.展开更多
Background: Human immunodeficiency virus and hepatitis B and C viruses are endemic in sub- Saharan African countries including Nigeria. Researchers have studied the burden of co-infection of HIV with hepatitis B and h...Background: Human immunodeficiency virus and hepatitis B and C viruses are endemic in sub- Saharan African countries including Nigeria. Researchers have studied the burden of co-infection of HIV with hepatitis B and hepatitis C but the risk factors and clinical presentation have not been much addressed especially in children. Methodology: This was a prospective cross sectional study that determined the prevalence, risk factors, clinical features, baseline CD4<sup>+</sup> count, CD4<sup>+</sup> percentage, and alanine aminotransferase (ALT) of newly diagnosed, HAART na?ve HIV co-infection among children who were managed at a Tertiary Hospital in Ilorin, Nigeria. Result: Of the 60 HIV- infected children recruited, 11.7% had HIV co-infection with HBV or HCV. Children with co-infec- tions (mean age 8.43 ± 2.37 years) were significantly older than their HIV mono-infected counterparts (mean age 5.25 ± 3.96 years) (p = 0.011). There was no significant difference between HIV monoinfection and HIV co-infection with respect to gender (p = 0.758), ethnicity (p = 0.707), religion of parents (p = 0.436), family type (p = 0.184), social class (p = 0.535), previous transfusion (p = 0.053), scarification (p = 0.612), female genital mutilation (p = 0.778), and sharing of clippers (p = 0.806). The mean BMI, immunological staging (p = 0.535), baseline ALT (p = 0.940), and mean baseline CD4<sup>+</sup> count (p = 0.928) were comparable. However, the body mass index of HIV co-infec- ted children decreased with age up till age 10 years. Conclusion: There were no risk factors, nor clinical features predictive of co-infection identified in this study. Co-infection did not negatively impact baseline, CD4<sup>+</sup> count and ALT.展开更多
HIV and HCV co-infection is a unique disease condition, and medical management of such condition is difficult due to severity and systemic complications. Added with heavy alcohol drinking, risk of liver injury increas...HIV and HCV co-infection is a unique disease condition, and medical management of such condition is difficult due to severity and systemic complications. Added with heavy alcohol drinking, risk of liver injury increases due to several pro-inflammatory responses that subsequently get involved with alcohol metabolism. Elevated levels of fatty acids have been reported both in viral infections as well as alcoholic liver disease though such investigations have not addressed the adverse event with dual viral infection of HIV and HCV along with heavy drinking. This case report of a patient with excessive alcohol drinking and first time diagnosis of HIV and HCV dual infection, elaborating concurrent alteration in Linoleic Acid (LA) levels and pro-inflammatory shift in ω-6/ω-3 ratio along with the elevations in liver injury markers. Elevated LA has been recently studied extensively for its role in alcoholic liver disease;and in the present case, we also found it to be clinically relevant to liver injury.展开更多
Direct-acting antiviral(DAA)therapies are efficacious for the achievement of sustained virologic response(SVR)in almost all treated hepatitis C virus(HCV)-infected patients.However,the impacts of HCV eradication on im...Direct-acting antiviral(DAA)therapies are efficacious for the achievement of sustained virologic response(SVR)in almost all treated hepatitis C virus(HCV)-infected patients.However,the impacts of HCV eradication on immune function and chronic immune activation in the long-term remain controversial and limited,especially in patients co-infected with human immunodeficiency virus(HIV).Indeed,although restoration of many immune responses clearly can be observed,several features of immune perturbations persist over time after HCV clearance.Understanding the degree and reasons of the partial recovery of the immune system in chronic HCV/HIV coinfection after HCV elimination is pivotal to avoid disease progression and possible long-term clinical outcomes in cured patients,as well as contributing to the development of immunotherapy drug design.展开更多
Background and Objective: HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) are very widespread in the world, however, less than 20% of the people affected are diagnosed and treated. This study aimed to determi...Background and Objective: HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) are very widespread in the world, however, less than 20% of the people affected are diagnosed and treated. This study aimed to determine the prevalence of HIV, HCV and HBV co-infections in pregnant women at Bangui Community University Hospital and the cost of screening. Methods: A cross-sectional study involving consenting pregnant women who came for antenatal care was performed. HIV, HCV antibodies and HBV antigens were detected using Exacto Triplex<sup>?</sup> HIV/HCV/HBsAg rapid test, cross-validated by ELISA tests. Sociodemographic and professional data, the modes of transmission and prevention of HIV and both hepatitis viruses were collected in a standard sheet and analyzed using the Epi-Info software version 7. Results: Pregnant women aged 15 to 24 were the most affected (45.3%);high school girls (46.0%), and pregnant women living in cohabitation (65.3%) were the most represented. Twenty-five (16.7%) worked in the formal sector, 12.7% were unemployed housewives and the remainder in the informal sector. The prevalence of HIV, HBV, and HCV viruses was 11.8%, 21.9% and 22.2%, respectively. The prevalence of co-infections was 8.6% for HIV-HBV, 10.2% for HIV-HCV, 14.7% for HBV-HCV and 6.5% for HIV-HBV-HCV. All positive results and 10% of negative results by the rapid test were confirmed by ELISA tests. The serology of the three viruses costs 39,000 FCFA (60 Euros) by ELISA compared to 10,000 FCFA (15.00 Euros) with Exacto Triplex<sup>?</sup> HIV/HCV/AgHBs (BioSynex, Strasbourg, France). Conclusion: The low level of education and awareness of hepatitis are barriers to development and indicate the importance of improving the literacy rate of women in the Central African Republic (CAR). Likewise, the high prevalence of the three viruses shows the need for the urgent establishment of a national program to combat viral hepatitis in the CAR.展开更多
Background and Objective: HIV infection is often associated with HBV and HCV infection, together leading to high morbidity and mortality in developing countries. The objective of this study is to describe the clinical...Background and Objective: HIV infection is often associated with HBV and HCV infection, together leading to high morbidity and mortality in developing countries. The objective of this study is to describe the clinical, biological, immunological and therapeutic profile of patients co-infected with HIV-HBV and/or HCV. Methods: A cross-sectional and descriptive study including 180 people living with HIV (PLWHIV) in the city of Kinshasa province was conducted. Socio-demographic, clinical, biological and serological characteristics were analyzed. Results: The frequency of HIV-HBV/HCV co-infection was 23.9%. The distribution of age and sex of patients did not differ significantly according to co-infection status. The notion of pedicure and manicure was significantly more observed in patients free from viral hepatitis (51.1% versus 32.6%, p = 0.034). The median duration of knowledge of the HIV status which was longer in the co-infected (4 years versus 2 years, p = 0.022). A lower median level of GPT was observed in co-infected compared to other patients (14 IU/L versus 20 IU/L, p = 0.041). Serum albumin (3.1 g/L versus 3.3 g/L, p = 0.034) and prothrombin (58.3% versus 65.6%, p = 0.045) were lower in HIV co-infected-VHB and/or VHC. The median INR was higher in co-infected than in other patients (1.6 versus 1.4;p = 0.009). Patients without therapy Antiretroviral (TARV) medication were more numerous in co-infected (20.9% versus 8.0%, p = 0.025). Conclusions: The profile of PLWHIV was dominated by the presence of pedicures and manicures with high transaminases and without anti-viral treatment.展开更多
文摘Background: The diagnosis of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) remains a constraint for some populations in sub-Saharan Africa. This study aimed to determine the prevalence of HBV and HCV in people living with HIV and to evaluate the performance of a combined rapid test for the simultaneous detection of HIV, HBV, and HCV. Methods: This is a cross-sectional study that took place from February 2017 to November 2018 and included 139 HIV-infected individuals followed up at different medical centers in Ouagadougou, Burkina Faso. HBV and HCV serology tests were performed on-site using finger prick whole blood with HIV/HCV/HBsAg combined rapid test and then serum with two reference tests “Architect HBsAg Qualitative” and “Architect HIV Ag/Ab Combo”. Results: The mean age of the participants was 57 ± 8 years. Of the 139 participants, 10% (14/139) were HIV-1 positive, 71.9% (100/139) were HIV-2 positive, and 18.0% (25/139) were HIV-1/HIV-2 coinfected. The sensitivity and specificity of the HIV/HCV/HBsAg combined rapid test were 33.33% vs 99.11% and 20% vs 99.25% compared to Architect HBsAg Qualitative and Architect HIV Ag/Ab Combo, respectively. The Kappa and Youden Index values were 0.4262 and 0.3244 and 0.2707 and 0.1925, respectively, compared to each of the two reference tests. Conclusion: The results show that the HIV/HCV/HBsAg combined rapid test has poor diagnostic efficiency and should not be recommended for the diagnosis of these viruses.
文摘Human immunodeficiency virus (HIV) is the infectious agent causing acquired immu-nodeficiency syndrome (AIDS),a deadliest scourge of human society. Hepatitis C virus (HCV) is a major causative agent of chronic liver disease and infects an estimated 170 million people worldwide,resulting in a serious public health burden. Due to shared routes of transmission,co-infection with HIV and HCV has become common among individuals who had high risks of blood exposures. Among hemophiliacs the co-infection rate accounts for 85%; while among injection drug users (IDU) the rate can be as high as 90%. HIV can accelerate the progression of HCV-related liver disease,particularly when immunodeficiency has developed. Although the effect of HCV on HIV infection is controversial,most studies showed an increase in mortality due to liver disease. HCV may act as a direct cofactor to fasten the progression of AIDS and decrease the tolerance of highly active antiretroviral therapy (HARRT). Conversely,HAART-related hepatotoxicity may enhance the progression of liver fibrosis. Due to above complications,co-infection with HCV and HIV-1 has imposed a critical challenge in the management of these patients. In this review,we focus on the epidemiology and transmission of HIV and HCV,the impact of the two viruses on each other,and their treatment.
文摘Background: Previous research has suggested an association between infection with hepatitis C virus (HCV) or with human immunodeficiency virus (HIV) and low platelet counts. This study estimates platelet count changes over time in HIV/HCV co-infected participants and compares them with the changes in platelet count among HIV mono-infected participants to test if HIV/HCV co-infection is associated with lower platelet counts. Methods: This retrospective cohort study included all HIV treatment naive patients from four sites in the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort with platelet count measurements between 2002 and 2009. We conducted a mixed effects linear regression modeling the mean change in platelet count per year while adjusting for age, sex, race, baseline CD4 cell count, and site. Index date was the first platelet count after 2002, and participants were censored upon initiation of treatment for HIV or HCV. Results: There were 929 HIV/HCV co-infected and 3558 HIV mono-infected participants with a mean follow-up time of 1.2 years. HIV/HCV co-infected participants had on average a slighter lower platelet count at baseline (234,040 vs. 242,780/μL;p-value = 0.004), and a more rapid mean reduction per year (7230 vs. 3580/μL;p-value 0.001) after adjusting for age, sex, baseline CD4 count. Conclusions: In treatment naive participants, HIV/HCV co-infection is associated with a more rapid decline in platelet count compared with HIV mono-infection.
基金This study was supported by a grant from Beijing Science and Technology Committee ( H010210120113 ) and a grant from Capital University of Medi-cine, Beijing.
文摘BACKGROUND:Co-infection of hepatitis C virus (HCV) and human immunodeficiency virus type 1 ( HIV-1 ) is common in hemophiliacs and drug abusers. To assess the interaction between HIV and HCV disease progression, we examined 82 HIV/HCV co-infection patients and 62 HCV infection patients. METHODS: Liver function, pathological changes, infec- tion duration, immune function and qualitative HCV-RNA and HCV antibody were compared retrospectively between the two groups of patients. RESULTS: Fourty-eight patients (58.5%) in the HIV/ HCV co-infection group and 53 patients (85.5%) in the HCV infection group showed abnormal liver function. No significant difference was observed in inflammation and fi- brosis in the two groups P =0.187, 0.954). However, liver abnormality in the patients with HIV/HCV co-infection appeared 8 years earlier than in those with HCV infection alone (P<0.001). As to immune function, the counts of CD4+T and CD8+ T in the HIV/HCV group were (226.35 ± 173.49)×106/L and (914. 40 ±448. 28)×106/L, whereas in the HCV group they were (752.31±251.69)×l06/L and (529.011170.67)×106/L respectively. The difference in the two groups was highly significant (P<0.001; P<0.001). The ratio of the number of people with both HCV-RNA and HCV antibody positive to the number of HCV-RNA positive and HCV antibody negative in the HIV/HCV group was 52:9, whereas in the HCV group it was 44:1 (P = 0.043). CONCLUSION: HIV/HCV co-infection can accelerate de- terioration of hepatitis C, which may be due to the effect of HIV on cellular immunity and humoral immunity of the body.
文摘Presence of the hepatitis C virus in HIV infected patients has an additional neurotoxic influence on the Central Nervous System. It has been described that HCV co-infection leads to neuropsychological impairment whose severity is greater than in mono-HIV infected subjects. In the present study we assessed the neuropsychological status of 46 human immunodeficiency virus (HIV)-infected individuals from the Warsaw Hospital for Infectious Diseases. For the purpose of cognitive assessment, neuropsychological tests measuring global cognitive functions, attention and perception, verbal memory, as well as non-verbal aspects of executive functions, e.g. visual monitoring and planning, were assessed. In 60% of the investigated patients, who were co-infected with the hepatitis C virus, the overall cognitive outcome observed was worse than in mono-HIV infected subjects. The following factors were taken into account: ART therapy’s influence on cognitive functions using the CPE rank (CNS Penetration Efficacy, 2010), route of HIV transmission, conditions of human existence and age of investigated patients. The present work should be treated as a preliminary research and interpreted in the context of several limitations described in the text.
文摘About 50% of people living with the HIV infection in Italy are co-infected with HCV. In this group of patients, the primary cause of mortality is liver disease, which accounts for up to 14% of deaths. HIV/HCV co-infection also exposes patients to a higher risk of progression to AIDS, a faster evolution towards cirrhosis, more frequent drug toxicity, and lower tolerance for antiretroviral therapy. Moreover, HCV infection can play a part in increasing immune system depression;neurological, cognitive and renal damage;and bone fragility. Hence an optimal antiretroviral regimen needs to be chosen for co-administration with anti-HCV therapy and timed appropriately to improve the prognosis of co-infected HIV/HCV patients. Unfortunately, however, data on the safety and efficacy of antiretroviral drugs in these patients is scarce, as are studies of pharmacokinetics in patients with advanced liver impairment. Furthermore, restoring adequate immune constitution seems not to slow the progression of liver disease, and the metabolic and hepatic toxicity of some antiretroviral drugs can even contribute to inflammatory and fibrogenic processes. It is therefore essential that HIV/HCV co-infected patients receive only medications capable of ensuring the best immune recovery but possessing the lowest potential to trigger immune reconstitution syndrome or hepatic and metabolic damage.
文摘Hepatitis C infection in people living with Human Immunodeficiency Virus (HIV) poses management challenges. Of the world’s population, 3% are estimated to have chronic Hepatitis C Virus (HCV) infection, which is responsible for about 70% of cases of chronic hepatitis (accelerated chronicity in the presence of HIV and for such major complications as cirrhosis and hepatocellular carcinoma. The fibrosis 4 (FIB-4) and Aspartate aminotransferase/platelet ratio index (APRI) scores are simple, inexpensive tests accessible to most people, and their performance has not yet been studied in C?te d’Ivoire. Objective: To prospectively evaluate the diagnostic performance of APRI and FIB-4 scores in liver damage in those co-infected with HIV/HCV in C?te d’Ivoire. Methods: This study was conducted over three months. The patients came from national blood transfusion center of the cities of Man and Daloa. The criteria for selecting respondents were at least 18 years of age and a positive test for HIV and HCV. APRI and FIB-4 scores were calculated for each patient from biological data obtained by COBAS C311 (Roche Hitachi, Japan). Statistical analyses were performed using GraphPad and MED-CALC software. Results: Our study involved 30 patients (men) of middle age (25 - 52 years), with extremes ranging from 0.67 to 8 for APRI and 0.201 to 22 for FIB-4. A predictive APRI and FIB4 score of significant hepatic fibrosis was observed in 23% of patients;however, 46% and 54% of patients for the APRI and FIB-4 score, respectively, would not have significant fibrosis. An APRI and FIB4 score not included in the classification limits of the type of fibrosis hepatitis was observed in 31% and 23% of patients, respectively. Conclusion: The performance of the APRI and FIB-4 biological scores analyzed according to the interpretation of their cut-off values would enable classifying about 70% and 77%, respectively, of the patient population in the stages of hepatitis C fibrosis.
文摘Background: Human immunodeficiency virus and hepatitis B and C viruses are endemic in sub- Saharan African countries including Nigeria. Researchers have studied the burden of co-infection of HIV with hepatitis B and hepatitis C but the risk factors and clinical presentation have not been much addressed especially in children. Methodology: This was a prospective cross sectional study that determined the prevalence, risk factors, clinical features, baseline CD4<sup>+</sup> count, CD4<sup>+</sup> percentage, and alanine aminotransferase (ALT) of newly diagnosed, HAART na?ve HIV co-infection among children who were managed at a Tertiary Hospital in Ilorin, Nigeria. Result: Of the 60 HIV- infected children recruited, 11.7% had HIV co-infection with HBV or HCV. Children with co-infec- tions (mean age 8.43 ± 2.37 years) were significantly older than their HIV mono-infected counterparts (mean age 5.25 ± 3.96 years) (p = 0.011). There was no significant difference between HIV monoinfection and HIV co-infection with respect to gender (p = 0.758), ethnicity (p = 0.707), religion of parents (p = 0.436), family type (p = 0.184), social class (p = 0.535), previous transfusion (p = 0.053), scarification (p = 0.612), female genital mutilation (p = 0.778), and sharing of clippers (p = 0.806). The mean BMI, immunological staging (p = 0.535), baseline ALT (p = 0.940), and mean baseline CD4<sup>+</sup> count (p = 0.928) were comparable. However, the body mass index of HIV co-infec- ted children decreased with age up till age 10 years. Conclusion: There were no risk factors, nor clinical features predictive of co-infection identified in this study. Co-infection did not negatively impact baseline, CD4<sup>+</sup> count and ALT.
文摘HIV and HCV co-infection is a unique disease condition, and medical management of such condition is difficult due to severity and systemic complications. Added with heavy alcohol drinking, risk of liver injury increases due to several pro-inflammatory responses that subsequently get involved with alcohol metabolism. Elevated levels of fatty acids have been reported both in viral infections as well as alcoholic liver disease though such investigations have not addressed the adverse event with dual viral infection of HIV and HCV along with heavy drinking. This case report of a patient with excessive alcohol drinking and first time diagnosis of HIV and HCV dual infection, elaborating concurrent alteration in Linoleic Acid (LA) levels and pro-inflammatory shift in ω-6/ω-3 ratio along with the elevations in liver injury markers. Elevated LA has been recently studied extensively for its role in alcoholic liver disease;and in the present case, we also found it to be clinically relevant to liver injury.
文摘Direct-acting antiviral(DAA)therapies are efficacious for the achievement of sustained virologic response(SVR)in almost all treated hepatitis C virus(HCV)-infected patients.However,the impacts of HCV eradication on immune function and chronic immune activation in the long-term remain controversial and limited,especially in patients co-infected with human immunodeficiency virus(HIV).Indeed,although restoration of many immune responses clearly can be observed,several features of immune perturbations persist over time after HCV clearance.Understanding the degree and reasons of the partial recovery of the immune system in chronic HCV/HIV coinfection after HCV elimination is pivotal to avoid disease progression and possible long-term clinical outcomes in cured patients,as well as contributing to the development of immunotherapy drug design.
文摘Background and Objective: HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) are very widespread in the world, however, less than 20% of the people affected are diagnosed and treated. This study aimed to determine the prevalence of HIV, HCV and HBV co-infections in pregnant women at Bangui Community University Hospital and the cost of screening. Methods: A cross-sectional study involving consenting pregnant women who came for antenatal care was performed. HIV, HCV antibodies and HBV antigens were detected using Exacto Triplex<sup>?</sup> HIV/HCV/HBsAg rapid test, cross-validated by ELISA tests. Sociodemographic and professional data, the modes of transmission and prevention of HIV and both hepatitis viruses were collected in a standard sheet and analyzed using the Epi-Info software version 7. Results: Pregnant women aged 15 to 24 were the most affected (45.3%);high school girls (46.0%), and pregnant women living in cohabitation (65.3%) were the most represented. Twenty-five (16.7%) worked in the formal sector, 12.7% were unemployed housewives and the remainder in the informal sector. The prevalence of HIV, HBV, and HCV viruses was 11.8%, 21.9% and 22.2%, respectively. The prevalence of co-infections was 8.6% for HIV-HBV, 10.2% for HIV-HCV, 14.7% for HBV-HCV and 6.5% for HIV-HBV-HCV. All positive results and 10% of negative results by the rapid test were confirmed by ELISA tests. The serology of the three viruses costs 39,000 FCFA (60 Euros) by ELISA compared to 10,000 FCFA (15.00 Euros) with Exacto Triplex<sup>?</sup> HIV/HCV/AgHBs (BioSynex, Strasbourg, France). Conclusion: The low level of education and awareness of hepatitis are barriers to development and indicate the importance of improving the literacy rate of women in the Central African Republic (CAR). Likewise, the high prevalence of the three viruses shows the need for the urgent establishment of a national program to combat viral hepatitis in the CAR.
文摘Background and Objective: HIV infection is often associated with HBV and HCV infection, together leading to high morbidity and mortality in developing countries. The objective of this study is to describe the clinical, biological, immunological and therapeutic profile of patients co-infected with HIV-HBV and/or HCV. Methods: A cross-sectional and descriptive study including 180 people living with HIV (PLWHIV) in the city of Kinshasa province was conducted. Socio-demographic, clinical, biological and serological characteristics were analyzed. Results: The frequency of HIV-HBV/HCV co-infection was 23.9%. The distribution of age and sex of patients did not differ significantly according to co-infection status. The notion of pedicure and manicure was significantly more observed in patients free from viral hepatitis (51.1% versus 32.6%, p = 0.034). The median duration of knowledge of the HIV status which was longer in the co-infected (4 years versus 2 years, p = 0.022). A lower median level of GPT was observed in co-infected compared to other patients (14 IU/L versus 20 IU/L, p = 0.041). Serum albumin (3.1 g/L versus 3.3 g/L, p = 0.034) and prothrombin (58.3% versus 65.6%, p = 0.045) were lower in HIV co-infected-VHB and/or VHC. The median INR was higher in co-infected than in other patients (1.6 versus 1.4;p = 0.009). Patients without therapy Antiretroviral (TARV) medication were more numerous in co-infected (20.9% versus 8.0%, p = 0.025). Conclusions: The profile of PLWHIV was dominated by the presence of pedicures and manicures with high transaminases and without anti-viral treatment.
