title: Low rate of sustained virological response in an outbreak of acute hepatitis C in HIV-infected patients.
abstract: Recent reports have suggested an increased risk of acute hepatitis C (AHC) infection in homosexual HIV-infected men and that early treatment with interferon-alfa, alone or associated with ribavirin, significantly reduces the risk of chronic evolution. A retrospective analysis of 38 HIV-infected patients who were consecutively diagnosed as developing AHC, defined by both seroconversion of anti-hepatitis C virus (HCV) antibodies and detection of serum HCV-RNA in those with previous negative results. Thirty-six patients were men with history of unprotected sexual intercourse with men and two were women with sexual and nosocomial risk factors. AHC infection was asymptomatic in 26 patients; asthenia and jaundice were the most frequent symptoms. HCV genotype 1 was present in 19 patients and genotype 4 in 14 patients. Thirty-five patients received early antiviral treatment with pegylated interferon-alfa associated with ribavirin; 15 of the 32 patients who completed the follow-up (47%) achieved a sustained virological response, as defined by undetectable HCV-RNA 6 months after the end of therapy. There is a risk of sexual transmission of HCV in HIV-infected men who have sex with men. In our experience, early treatment of AHC with pegylated interferon-alfa plus ribavirin in HIV patients achieves poor results.
authors.affiliation: Infectious Diseases, University of Barcelona, Spain. mlaguno@clinic.ub.es
authors.forename: Montserrat
authors.initials: M
authors.lastname: Laguno
authors.forename: Maria
authors.initials: M
authors.lastname: Martínez-Rebollar
authors.forename: Iñaki
authors.initials: I
authors.lastname: Perez
authors.forename: Josep
authors.initials: J
authors.lastname: Costa
authors.forename: Maria
authors.initials: M
authors.lastname: Larrousse
authors.forename: Marta
authors.initials: M
authors.lastname: Calvo
authors.forename: Montse
authors.initials: M
authors.lastname: Loncá
authors.forename: Ana
authors.initials: A
authors.lastname: Muñoz
authors.forename: Ana
authors.initials: A
authors.lastname: González-Cordón
authors.forename: José Luís
authors.initials: JL
authors.lastname: Blanco
authors.forename: Esteban
authors.initials: E
authors.lastname: Martínez
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Gatell
authors.forename: Josep
authors.initials: J
authors.lastname: Mallolas
mesh_terms: D000208:Acute Disease; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000494:pharmacology*; D004196:Disease Outbreaks; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006679:HIV Seropositivity / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology*; D006526:Hepatitis C / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology*; D018937:Hepatitis C Antibodies / Q000276:immunology*; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D012189:Retrospective Studies; D012254:Ribavirin / Q000008:administration & dosage / Q000494:pharmacology*; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
chemical_list: D000998:Antiviral Agents; D018937:Hepatitis C Antibodies; D016898:Interferon-alpha; D012254:Ribavirin