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Mulu W, Gidey B, Chernet A, Alem G, Abera B. Hepatotoxicity and associated risk factors in HIV-infected patients receiving antiretroviral therapy at Felege Hiwot Referral Hospital, Bahirdar, Ethiopia. Ethiop J Health Sci 2015; 23:217-26. [PMID: 24307821 PMCID: PMC3847531 DOI: 10.4314/ejhs.v23i3.4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background In Human Immunodeficiency Virus (HIV) infected patients on antiretroviral treatment (ART), hepatotoxicity is life threatening. Its outcome may lead to liver failure and death. This study was conducted to determine the rate and determinants of elevated alanine amino transferase (ALT) (referred as >40IU/L for both males and females). Methods A cross sectional study was conducted on HIV infected individuals who are on ART and suspected of drug resistance at Felege Hiwot Referral Hospital, Bahir Dar from July to December 2012. Venous bloods were collected from each patient and processed parallely to determine ALT, number of HIV RNAs, CD4 and CD8 T cells count, anti hepatitis C virus (HCV) and hepatitis B surface antigen. Results Out of 269 HIV infected patients receiving ART, 32% were confirmed of grades 1–4 levels of elevated ALT. The rate of severe hepatotoxicity (grade 3 and 4) was 1.84%. Patients with increased CD8 T cell counts (P=0.011; AOR=1.82; CI: 1.12 –2.54), alcohol over use (P=0.014; AOR = 1.23; CI: 1.36–3.29) and detectable HIV-1 RNA copies (P=0.015; AOR=2.07; CI: 1.15–3.74) independently predicts the elevation of ALT. Conclusions In HIV infected patients on ART, extreme elevations of ALT were infrequent but minor elevations were common so that patient-linked variables such as use of alcohol intake must be taken in to account for better clinical management of ART patients. The role of active HCV co-infection on the treatment outcome of ART should be further studied.
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Affiliation(s)
- Wondemagegn Mulu
- Department of Medical Microbiology, Immunology and Parasitology, Bahirdar University, Ethiopia
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Anigilaje EA, Olutola A. Prevalence and Clinical and Immunoviralogical Profile of Human Immunodeficiency Virus-Hepatitis B Coinfection among Children in an Antiretroviral Therapy Programme in Benue State, Nigeria. ISRN PEDIATRICS 2013; 2013:932697. [PMID: 23691352 PMCID: PMC3649331 DOI: 10.1155/2013/932697] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 03/17/2013] [Indexed: 12/14/2022]
Abstract
Background. Nigeria has the world largest burden of paediatric HIV and is also highly endemic for Hepatitis B virus (HBV). However, relatively little is known regarding the prevalence of HBV-HIV coinfections among Nigerian children. Methods. A retrospective study among treatment naive HIV-infected children attending the pediatric clinic of the APIN Plus/Harvard PEPFAR program of the Federal Medical Centre, Makurdi, between June 2008 and June 2012. Results. The mean age of the 395 subjects studied was 7.53 ± 4.23 years. Thirty-one subjects (7.8%) were positive for HBV. No subject was HIV-HBV-HCV triply infected. Significantly higher HIV-HBC coinfections were found, in older subjects (11-15 years), subjects that did not receive nor complete Hepatitis B vaccinations, and subjects that had a severe immunosuppression of < 15% with respective P values of 0.00, 0.01, and 0.00. HIV-HBV co-infection did not significantly impact on other baseline characteristics including, gender, WHO clinical stage, median absolute CD4 count, mean viral load, median ALT, and hepatotoxicity. Conclusion. A high seroprevalence of HBV among this cohort of HIV-infected children contributes to the calls for pre-ART screening for HBV and the necessary paradigm shift in the ART nucleoside backbone to include agent(s) more dually effective against HIV and HBV.
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Affiliation(s)
| | - Ayodotun Olutola
- Center for Clinical Care and Clinical Research, 29 Mambilla Street, Off Aso Drive, Maitama, Abuja, Nigeria
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Zoufaly A, Onyoh EF, Tih PM, Awasom CN, Feldt T. High prevalence of hepatitis B and syphilis co-infections among HIV patients initiating antiretroviral therapy in the north-west region of Cameroon. Int J STD AIDS 2013; 23:435-8. [PMID: 22807539 DOI: 10.1258/ijsa.2011.011279] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Hepatitis B virus (HBV) and syphilis co-infections contribute significantly to HIV-associated morbidity and mortality, but the burden of these diseases is not fully appreciated in sub-Saharan Africa, as prevalence data are scarce. Both infections often remain undiagnosed in resource-limited settings because routine testing is not a part of most of the national guidelines. Epidemiological studies provide important information on prevalence and risk factors for such co-infections and can provide guidance for clinical management and for the development of test strategies. We analysed data on baseline characteristics, CD4 cell counts, HBV and syphilis co-infection rates of 690 patients enrolling for antiretroviral therapy in rural Cameroon. The prevalence of both hepatitis B surface antigen (HBsAg, 12.6%, 95% CI 10.1-15.1) and treponemal antibodies (11.4%, 95% CI 8.9-13.7) was high, with significantly higher prevalences for both infections in men; detection of treponemal antibodies increased with age. Although liver enzyme elevations were common, they were not useful to identify HBsAg-positive patients. In this setting, routine serological screening for HBV and syphilis co-infection should be considered to avoid complications and ongoing transmission.
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Affiliation(s)
- A Zoufaly
- University Medical Center Hamburg, Department of Medicine/Infectious Diseases Unit, Martinistrasse 52, Hamburg 20251, Germany.
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Is 1 Alanine Transaminase >200 IU Enough to Define an Alanine Transaminase Flare in HIV-Infected Populations? A New Definition Derived From a Large Cohort Study. J Acquir Immune Defic Syndr 2009; 52:391-6. [DOI: 10.1097/qai.0b013e3181ab73cc] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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The role of antiretroviral therapy in the incidence of pancreatitis in HIV-positive individuals in the EuroSIDA study. AIDS 2008; 22:47-56. [PMID: 18090391 DOI: 10.1097/qad.0b013e3282f03094] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM This study investigated the incidence of pancreatitis and its association with antiretroviral therapy (ART), focussing on stavudine and didanosine. METHODS EuroSIDA has collected information on pancreatitis since Summer 2001. All identified cases have been verified by the coordinating centre. Individuals were followed from June 2001 or the date of entry into EuroSIDA (whichever occurred later) until a diagnosis of pancreatitis or the last study visit. Factors associated with pancreatitis were investigated using Poisson regression. Cumulative lengths of exposure to didanosine without stavudine, stavudine without didanosine, stavudine with didanosine, and other ART were time-updated variables. Treatment variables were fitted with a 6-month time lag. RESULTS There were 43 (nine presumptive) pancreatic events in 9678 individuals during 33 742 person-years (incidence 1.27/1000 person-years). The incidence among those with no, 2 or less and over 2 years' exposure to ART including stavudine and didanosine was 1.24, 1.73 and 0.78/1000 person-years, respectively. In multivariable analysis, higher baseline CD4 cell counts were associated with a decreased risk of pancreatitis. There was no evidence of an association of pancreatitis with cumulative exposure to didanosine and stavudine, didanosine without stavudine, stavudine without didanosine, or other ART. CONCLUSION We observed a low overall rate of pancreatitis in the years 2001-2006, and did not find an association of an increased incidence of pancreatitis with cumulative exposure to antiretroviral agents generally, and to didanosine and stavudine in particular.
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Cacoub P, Piroth L. Prise en charge des malades coinfectés VIH-VHC et VIH-VHB. ACTA ACUST UNITED AC 2007; 31:887-94. [DOI: 10.1016/s0399-8320(07)73986-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
Antiretroviral therapy (ART) for HIV infection frequently has been associated with elevated liver enzyme levels. Determining the cause of elevated liver enzyme levels in patients who have HIV is difficult because ART usually consists of three different drugs, patients may be taking additional hepatotoxic medications and patients who have HIV often suffer from other liver diseases. Several agents, however, are recognized as having noteworthy and specific patterns of toxicity. This article reviews the different HIV drug classes, incidence of elevated liver enzyme values by class and by individual drug, risk factors, specific toxicities, and possible mechanisms of injury.
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Affiliation(s)
- Mamta K Jain
- University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9113, USA.
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Hoffmann CJ, Thio CL. Clinical implications of HIV and hepatitis B co-infection in Asia and Africa. THE LANCET. INFECTIOUS DISEASES 2007; 7:402-9. [PMID: 17521593 DOI: 10.1016/s1473-3099(07)70135-4] [Citation(s) in RCA: 216] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Hepatitis B virus (HBV) is the leading cause of chronic liver disease and liver-related death worldwide, with the majority of these cases occurring in areas of Africa and Asia where HBV prevalence is high. Many of the countries that are affected by hepatitis B are also affected by a high HIV burden, leading to frequent HIV/HBV co-infection. The consequences of co-infection, including increased liver-related morbidity and mortality, increased hepatitis B viral replication, immune reconstitution to HBV in the setting of antiretroviral therapy, and hepatotoxicity from antiretroviral drugs, are especially important in regions with expanding antiretroviral programmes. Little data, however, are available on HIV/HBV co-infection from regions with high chronic hepatitis B prevalence. This Review discusses the epidemiology, natural history, pathogenesis, and management of HIV/HBV co-infection from these areas. Topics for future research relevant to HIV/HBV co-infection in Africa and Asia are also highlighted.
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Affiliation(s)
- Christopher J Hoffmann
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA.
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Lapadula G, Izzo I, Costarelli S, Cologni G, Bercich L, Casari S, Gambarotti M, Torti C. Dideoxynucleoside HIV reverse transcriptase inhibitors and drug-related hepatotoxicity: a case report. J Med Case Rep 2007; 1:19. [PMID: 17488516 PMCID: PMC1868747 DOI: 10.1186/1752-1947-1-19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2007] [Accepted: 05/08/2007] [Indexed: 11/27/2022] Open
Abstract
This report regards the case of a 43 year-old HIV-positive woman who developed an episode of serious transaminase elevation during stavudine-including antiretroviral therapy. Diagnostic assessment ruled out hepatitis virus co-infection, alcohol abuse besides other possible causes of liver damage. No signs of lactic acidosis were present. Liver biopsy showed portal inflammatory infiltrate, spotty necrosis, vacuoles of macro- and micro-vesicular steatosis, acidophil and foamy hepatocytes degeneration with organelles clumping, poorly formed Mallory bodies and neutrophil granulocytes attraction (satellitosis). A dramatic improvement in liver function tests occurred when stavudine was discontinued and a new antiretroviral regimen with different nucleoside reverse transcriptase inhibitors was used. The importance of considering hepatotoxicity as an adverse event of HAART including stavudine, even in absence of other signs of mitochondrial toxicity should therefore be underlined. Liver biopsy may provide further important information regarding patients with severe transaminase elevation, for a better understanding of the etiology of liver damage.
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Affiliation(s)
- Giuseppe Lapadula
- Institute of Infectious and Tropical Diseases, University of Brescia, Italy
| | - Ilaria Izzo
- Institute of Infectious and Tropical Diseases, University of Brescia, Italy
| | - Silvia Costarelli
- Institute of Infectious and Tropical Diseases, University of Brescia, Italy
| | - Giuliana Cologni
- Institute of Infectious and Tropical Diseases, University of Brescia, Italy
| | - Luisa Bercich
- Service of Morbid Anatomy, Spedali Civili di Brescia, Italy
| | - Salvatore Casari
- Institute of Infectious and Tropical Diseases, University of Brescia, Italy
| | | | - Carlo Torti
- Institute of Infectious and Tropical Diseases, University of Brescia, Italy
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Parsons TD, Tucker KA, Hall CD, Robertson WT, Eron JJ, Fried MW, Robertson KR. Neurocognitive functioning and HAART in HIV and hepatitis C virus co-infection. AIDS 2006; 20:1591-5. [PMID: 16868439 DOI: 10.1097/01.aids.0000238404.16121.47] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study examined the effects of HAART on neurocognitive functioning in persons with hepatitis C virus (HCV) and HIV co-infection. DESIGN A prospective study examining neurocognitive performance before and after HAART initiation. METHOD Participant groups included a mono-infected group (45 HIV+/HCV- participants) and a co-infected group (20 HIV+/HCV+ participants). A neuropsychological battery (attention/concentration, psychomotor speed, executive functioning, verbal memory, visual memory, fine motor, and gross motor functioning) was used to evaluate all participants. After 6 months of HAART, 31 HIV+ mono-infected and 13 HCV+/HIV+ co-infected participants were reevaluated. RESULTS Neurocognitive functioning by domain revealed significantly worse performance in the co-infected group when compared to the monoinfected group on domains of visual memory and fine motor functioning. Assessment of neurocognitive functioning after antiretroviral therapy revealed that the co-infected group was no longer performing worse than the monoinfected group. CONCLUSIONS The findings of the current study suggest that persons with HCV+/HIV+ co-infection may have greater neurocognitive declines than persons with HIV infection alone. HCV+/HIV+ co-infection may accelerate the progression of HIV related neurocognitive decline.
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Affiliation(s)
- Thomas D Parsons
- University of North Carolina, Chapel Hill, North Carolina 27599-7025, USA.
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Torti C, Lapadula G, Puoti M, Casari S, Uccelli MC, Cristini G, Bella D, Pastore G, Ladisa N, Minoli L, Sotgiu G, Caputo SL, Bonora S, Carosi G. Influence of genotype 3 hepatitis C coinfection on liver enzyme elevation in HIV-1-positive patients after commencement of a new highly active antiretroviral regimen: results from the EPOKA-MASTER Cohort. J Acquir Immune Defic Syndr 2006; 41:180-5. [PMID: 16394850 DOI: 10.1097/01.qai.0000192005.08153.a3] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND The independent role of hepatitis C virus (HCV) genotype 3 in liver transaminase elevation following highly active antiretroviral regimens is still controversial. METHODS Analysis of data from a cohort of 492 HIV/HCV-coinfected patients was conducted using an intention-to-treat approach. Incidence of grade > or = III liver transaminase elevation was estimated per 100 patient-years of follow-up. Univariate and multiple proportional hazards regression analysis of factors that may predict liver enzyme elevation was performed. RESULTS The incidence of grade > or = III hepatotoxicity was 25 per 100 patient-years among patients coinfected with HCV genotype 3 and 11 per 100 patient-years among those with other genotypes. On multiple proportional hazard regression analysis, time-to-grade > or = III liver enzyme elevation was directly correlated with HCV genotype 3 (hazards ratio [HR]: 2.0, 95% CI: 1.3 to 2.9; P = 0.001), male gender (HR: 2.7; 95% CI: 1.3 to 5.7; P = 0.007), chronic hepatitis B virus infection (HR: 2.9, 95% CI: 1.5 to 5.9; P = 0.002), and alanine aminotransferase level at baseline (per 10 IU/L HR: 1.10; 95% CI: 1.06 to 1.15; P < 0.001). In the same model, higher CD4 T-cell counts at baseline were inversely correlated with risk of hepatotoxicity (HR: 0.998; 95% CI: 0.997 to 0.999; P = 0.036). Moreover, among patients experienced to antiretroviral drugs, previous grade > or = III hepatotoxicity (HR: 2.8; 95% CI: 1.8 to 4.3; P < 0.001) was an adjunctive independent risk factor. CONCLUSIONS HIV-positive patients coinfected with HCV genotype 3 displayed a higher risk of relevant hepatotoxicity, independently from other clinical variables. The impact of HCV genotype outweighed the role of drugs in determining hepatotoxicity.
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Affiliation(s)
- Carlo Torti
- Istituto di Malattie Infettive e Tropicali, Università di Brescia, Brescia, Italy.
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Seminari E, Gentilini G, Galli L, Hasson H, Danise A, Carini E, Dorigatti F, Soldarini A, Lazzarin A, Castagna A. Higher plasma lopinavir concentrations are associated with a moderate rise in cholestasis markers in HIV-infected patients. J Antimicrob Chemother 2005; 56:790-2. [PMID: 16143711 DOI: 10.1093/jac/dki314] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the correlation between liver function markers (necrosis and cholestasis) and plasma lopinavir levels in a cohort of HIV-infected patients treated with lopinavir and ritonavir. PATIENTS AND METHODS The blood samples for determining steady-state C(trough) lopinavir levels and analysing liver function were drawn from fasting patients. Steady-state C(trough) lopinavir levels, liver function and immuno-virological markers were assessed on the same day. Plasma lopinavir and ritonavir levels were determined by means of high-performance liquid chromatography. RESULTS One hundred and forty-nine patients were included in the analysis [57 were HCV co-infected (34%) and 10 were HBV co-infected (6.7%)]; they had been treated with lopinavir/ritonavir for a median of 232 days (range 132-282). All patients received lopinavir/ritonavir [400/100 mg twice daily or 533/133 mg twice daily if amprenavir or a non-nucleoside reverse transcriptase inhibitor (NNRTI) was part of therapy] and concomitant therapy with NRTI(s). Median (interquartile) lopinavir trough levels were 6391 ng/mL (4121-8726), 5662 (3585-8893) and 6819 ng/mL (5324-8726) in the patients with HIV alone and those with HIV/HCV (or HBV) co-infection, respectively (P = not significant). Univariate analysis showed a significant association between the cholestasis markers and C(trough) lopinavir level. Multivariate analysis selected only gamma glutamyltranspeptidase (GGT) (OR = 1.010, 95% CI: 1.002-1.021) as being independently associated with plasma lopinavir levels of >6425 ng/mL; alkaline phosphatase (OR = 1.004, 95% CI: 1.000-1.010; P = 0.08) and total bilirubin (OR = 3.118, 95% CI: 0.980-11.715; P = 0.07) were not associated. CONCLUSIONS Elevated lopinavir concentrations are associated with raised GGT.
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Affiliation(s)
- Elena Seminari
- Infectious Disease Department, San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20122 Milan, Italy.
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Braitstein P, Palepu A, Dieterich D, Benhamou Y, Montaner JSG. Special considerations in the initiation and management of antiretroviral therapy in individuals coinfected with HIV and hepatitis C. AIDS 2004; 18:2221-34. [PMID: 15577534 DOI: 10.1097/00002030-200411190-00002] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Although hepatitis C (HCV) treatment efficacy has improved in recent years, the majority of HIV/HCV-coinfected individuals may not enjoy the full benefits of these treatments and appropriate HIV management is crucial. Evidence is accumulating regarding the impact of HIV/HCV coinfection on the response to, and safety and tolerability of, antiretroviral therapy (ART) in this population. METHODS Computerized, English-language literature searches of MEDLINE and PubMed databases (January 1985 to May 2004) for studies of HIV and HCV infection in humans to examine critically (a) the impact of HCV on the HIV virologic and immunologic response to ART; (b) the safety and tolerability of ART in coinfected individuals; and (c) the relationship between immune suppression and immune restoration on hepatic injury. RESULTS Three key messages emerged regarding the use of ART in HIV/HCV-coinfected individuals: (a) although HCV appeared to have no impact on HIV virologic response, the data are equivocal regarding immunologic response; (b) morbidities associated with HCV infection, such as insulin resistance, diabetes, mitochondrial dysfunction, and liver inflammation, are also associated toxicities of ART, and (c) both immune suppression and restoration can contribute to the onset and acceleration of HCV-related liver disease. CONCLUSIONS The CD4 cell count threshold for initiating ART in HIV/HCV-coinfected patients may be higher because of the impact of immune suppression and restoration on the onset of HCV-associated liver disease and the possibility of a blunted immune response to ART at lower CD4 cell counts. Further, overlapping morbidity between HCV-related mitochondrial and metabolic disease manifestations and ART toxicities warrant careful attention by clinicians.
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Affiliation(s)
- Paula Braitstein
- British Columbia Center for Excellence in HIV/AIDS, University of British Columbia, Vancouver, Canada.
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Ruan YH, Hong KX, Liu SZ, He YX, Zhou F, Qin GM, Chen KL, Xing H, Chen JP, Shao YM. Community-based survey of HCV and HIV coinfection in injection drug abusers in Sichuan Province of China. World J Gastroenterol 2004; 10:1589-93. [PMID: 15162531 PMCID: PMC4572760 DOI: 10.3748/wjg.v10.i11.1589] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
AIM: To investigate the prevalence and risk factors of HCV/HIV coinfection in injection drug abusers (IDAs) in Lianshan Yi Autonomous Prefecture of Sichuan province, China.
METHODS: From November 8, 2002 to November 29, 2002, a community-based survey was conducted to investigate the demographic characteristics, patterns of shared injectors devices and sexual behaviors in IDAs. Blood samples were also collected to test HCV and HIV infection. A total of 379 subjects were recruited in the study through community outreach and peer recruiting methods.
RESULTS: Of the 379 IDAs, the HCV prevalence and HIV prevalence were 71.0% and 11.3%, respectively, and HCV/HIV coinfection was 11.3%. HCV infection was found in 100% and 67.3% of HIV-positive and HIV-negative IDAs, respectively. HIV prevalence was 16.0% in HCV positive IDAs while none of the HCV negative IDAs was positive for HIV. Ethnicity, shared needles or syringes and cotton in the past 3 mo and syphilis infection were associated with HCV/HIV coinfection shown by univariate analysis using chi-square test. Multivariate logistic regression analysis showed that shared needles or syringes in the past 3 mo (Odds ratio = 3.121, 95% CI: 1.278-7.617, P < 0.05) and syphilis infection (Odds ratio = 2.914, 95% CI: 1.327-6.398, P < 0.01) were significantly associated with HCV infection. No statistically significant association was found in univariate analysis between sexual behaviors and HCV/HIV coinfection.
CONCLUSION: Shared needles and syringes in the past 3 mo and syphilis infection were significantly associated with HCV infection. Further sero-epidemiological prospective cohort studies should be conducted to clarify the impact of syphilis and high risk sexual behaviors on HCV transmission through unprotected sexual intercourse.
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Affiliation(s)
- Yu-Hua Ruan
- Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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