title: Clinical and epidemiological features of patients with chronic hepatitis C co-infected with HIV.
abstract: Co-infection with hepatitis C virus (HCV) and human immunodeficiency virus (HIV) is increasingly common and affects the clinical course of chronic hepatitis C. Highly active antiretroviral therapy has improved the life expectancy of HIV infected patients, but, by extending survival, it permits the development of HCV cirrhosis. This study tried to evaluate clinical and epidemiological features of patients with chronic hepatitis C co-infected with HIV. We evaluated 134 HCV-infected patients: i) group A-- 65 co-infected HCV/HIV patients, ii) group B-- 69 mono-infected HCV patients. The impact of HIV infection on HCV liver disease was analyzed using Child's score, ultrasound findings and liver histology. Patients were subjected to HCV genotyping and anti-HBs dosage. Patients mean age was 42.4 years (+/-9.1) and 97 (72.4%) were males. Injected drug use and homo/bisexual practice were more frequently encountered in the co-infected group: 68.3% and 78.0%, respectively. Antibodies against hepatitis B virus (anti-HBs) were found in only 38.1% of the patients (66.7% group A x 33.3% group B). Ten out of 14 individuals (71.4%) who had liver disease (Child B or C) and 25 out of 34 (73.5%) who showed ultrasound evidence of chronic liver disease were in the co-infection group. HCV genotype-2/3 was more frequently encountered in co-infected patients (36.9% group A vs. 21.8% group B).
  
  
  CONCLUSIONS
  a) HIV infection seems to adversely affect the clinical course of chronic hepatitis C, b) injected drug use, bi/homosexual practice and genotype-2/3 were more frequently encountered in co-infected patients, c) immunization against HBV should be encouraged in these patients.
authors.affiliation: Department of Medicine, Gastro-Hepatology Service, Federal University of Bahia, Salvador, BA, Brazil. elbraga@ig.com.br
authors.forename: Eduardo Lorens
authors.initials: EL
authors.lastname: Braga
authors.forename: André Castro
authors.initials: AC
authors.lastname: Lyra
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Ney-Oliveira
authors.forename: Lourianne
authors.initials: L
authors.lastname: Nascimento
authors.forename: Adriano
authors.initials: A
authors.lastname: Silva
authors.forename: Carlos
authors.initials: C
authors.lastname: Brites
authors.forename: Rosicreuza
authors.initials: R
authors.lastname: Marbak
authors.forename: Luiz Guilherme Costa
authors.initials: LG
authors.lastname: Lyra
mesh_terms: D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology* / Q000473:pathology; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index