Clinical and histological characteristics of HIV and hepatitis C virus-co-infected patients in Brazil: a case series study.
Hepatitis C virus (HCV) is an important factor contributing to morbidity and mortality in patients co-infected with HIV and HCV. In addition, liver biopsy is an important tool in the clinical management of these patients. Although liver biopsy is controversial, it is recommended for all patients. Data regarding the clinical and histological characteristics of these patients are scarce not only in Brazil but in Latin America as a whole. With the goal of better understanding these characteristics and the benefit of liver biopsy indications in this disease setting, data collected from 234 patients followed from 1996 to 2004 at Casa da AIDS, São Paulo, were analyzed. The following variables were extracted from the patients' medical files at the time of liver biopsy: sex, age, hepatitis C infection risk factors, hepatitis C infection duration, ALT levels, CD4+ T cell counts, history of alcohol abuse, history of antiretroviral therapy, HCV genotype, and liver histological alterations.


CONCLUSIONS
1 - Hepatitis C virus 1 and 3 were the most frequently identified genotypes and were diagnosed in 72% and 25.5% of cases respectively; 2 - Structural liver alterations were found to be mild or absent in 48.2% (113/234) of the analyzed patients; 3 - Fifty-three patients (23%) had normal ALT levels and 4 - Significant liver architectural changes (F2-F3) were evident in 22.5% of the patients with normal ALT levels.
Mendes-Correa
Maria Cássia
MC
Casa da AIDS, Division of Infectious Diseases, Hospital das Clinicas, São Paulo University, São Paulo, SP, Brazil. cassiamc@uol.com.br
Widman
Azzo
A
Brussi
Maria Luiza Paes
ML
Guastini
Cristina Fátima
CF
Cavalheiro
Norma de Paula
Nde P
Melo
Carlos Eduardo
CE
Barone
Antonio Alci
AA
Gianini
Reinaldo José
RJ
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001706:Biopsy; D001938:Brazil; D018791:CD4 Lymphocyte Count; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D019698:Hepatitis C, Chronic / Q000150:complications / Q000201:enzymology / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000201:enzymology / Q000473:pathology*; D008103:Liver Cirrhosis / Q000473:pathology / Q000821:virology*; D008297:Male; D012720:Severity of Illness Index; D013997:Time Factors; D019562:Viral Load
D019380:Anti-HIV Agents; D000410:Alanine Transaminase