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
目的分析新疆地区人类免疫缺陷病毒1型（human immunodeficiency virus type 1,HIV-1）/丙型肝炎病毒（hepatitis C virus,HCV）混合感染者体内HCV各基因型在6个月时间间隔前后基因变化规律,为针对HCV制定预防治疗策略和后续的研究提供...目的分析新疆地区人类免疫缺陷病毒1型（human immunodeficiency virus type 1,HIV-1）/丙型肝炎病毒（hepatitis C virus,HCV）混合感染者体内HCV各基因型在6个月时间间隔前后基因变化规律,为针对HCV制定预防治疗策略和后续的研究提供基础。方法对新疆地区2013年4月确认为HIV-1抗体阳性的102例感染者进行HCV抗体检测,HCV抗体阳性的研究对象在6个月后（2013年10月）进行第二次采血。对HCV抗体阳性的2次标本抽提血浆病毒RNA,反转录后扩增HCV 5′UTR基因,将所得到的序列与HCV的国际标准株进行比较,确定被检样本的HCV基因型。基于2次采样毒株的序列变异,使用MEGA 6软件计算其基因离散率,使用Beast v1.8.0软件分析起源时间和进化速率。结果 102例HIV-1感染者中有89例（87.25%）HCV抗体阳性,其中成功扩增出HCV 5′UTR基因2次序列的有77例（77/89,86.52%）。HCV 5′UTR基因片段分型结果显示有4种基因型：1a（9/77,11.69%）,1b（31/77,40.26%）,3a（24/77,31.17%）,3b（13/77,16.88%）。HCV的1b基因型6个月后样本的组内基因离散率（0.025±0.007）%明显大于首次采样的（0.001±0.001）%,其他3种基因型的基因离散率在6个月后无明显变化。HCV的5′UTR基因平均进化速率为1.62×10^-3（95%HPD 1.52×10-3～5.38×10^-3）替换/（位点·年）,各基因亚型之间的进化速率相差1～3倍,3a亚型祖先株形成时间最为久远。结论新疆地区HIV-1感染者中静脉吸毒人群合并HCV感染率高,HCV的3种基因型（1a、3b、3a）在HIV-1感染者体内稳定存在,总体变异不大,但1b基因型随着时间的推移相对比较活跃。展开更多
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.
