title: Epidemiological, immunological and virological characteristics, and disease progression of HIV-1/HCV-co-infected patients from a southern Brazilian population.
abstract: A cross-sectional study was carried out in order to describe the epidemiological, immunological and virological characteristics, and the disease progression of hepatitis C virus (HCV)/human immunodeficiency virus type 1 (HIV-1)- co-infected patients from a southern Brazilian population. Of 778 HIV-1-infected individuals enrolled in the study from September 2001 to December 2003, and followed up until June 2004, 757 were tested for anti-HCV antibodies. Of these, 159 (21.0%) showed positive results for anti-HCV. Males, individuals in the 25 to 34 year age range, and individuals of lower economic levels were more likely to be seropositive for both viruses [prevalence rate (PR), 2.04; 95% confidence interval (95% CI), 1.43-2.92; p<0.001]. The anti-HCV reactivity was also associated with blood routes of transmission (PR, 2.20; 95% CI, 1.28-3.77; p<0.001), intravenous drug use (PR, 5.79; 95% CI, 4.74-7.07; p<0.001), self-reported previous sexually transmitted diseases (PR, 1.55; 95% CI, 1.18-2.04; p=0.002), VDRL positivity (PR, 2.87; 95% CI, 2.40-3.43; p<0.001), and anti-HTLV I/II reactivity (PR, 5.09; 95% CI, 4.16-6.23; p<0.001). In the follow-up period, the HCV/HIV-1-co-infected patients showed a trend toward lower CD4+ T-cell counts, higher HIV-1 RNA plasma viral load and faster disease progression than patients infected only with HIV-1, but significant differences were not observed. Although there were proportionately more deaths in the HCV/HIV-1-co-infected group, the use of highly active antiretroviral therapy (HAART) was a string predictor of increased CD4+ T-cell counts and decreased HIV-1 RNA plasma levels, suggesting that HAART is more important to the immunological and virological outcomes in HIV-1 infection than is HCV co-infection status.
authors.affiliation: Health Sciences Center, Department of Pathology, Clinical Analysis and Toxicology, University Hospital of Londrina State University, CEP 86038-440, Londrina, Paraná, Brazil. reiche@sercomtel.com.br
authors.forename: Edna Maria Vissoci
authors.initials: EM
authors.lastname: Reiche
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Bonametti
authors.forename: Helena Kaminami
authors.initials: HK
authors.lastname: Morimoto
authors.forename: Arilson Akira
authors.initials: AA
authors.lastname: Morimoto
authors.forename: Susana Lilian
authors.initials: SL
authors.lastname: Wiechemann
authors.forename: Tiemi
authors.initials: T
authors.lastname: Matsuo
authors.forename: Fernando
authors.initials: F
authors.lastname: Vissoci Reiche
authors.forename: Ingridt Hildegard
authors.initials: IH
authors.lastname: Vogler
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D018791:CD4 Lymphocyte Count; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D006679:HIV Seropositivity; D015497:HIV-1 / Q000276:immunology*; D016174:Hepacivirus / Q000276:immunology*; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D006801:Humans; D008297:Male; D012367:RNA, Viral / Q000097:blood; D016019:Survival Analysis
chemical_list: D012367:RNA, Viral