Clinical characteristics of coinfection with hepatitis C virus in HIV-positive patients

Abstract

INTRODUCTION: Patients with HIV are commonly coinfected with hepatitis C virus (HCV) mostly due to similar routes of transmission, especially in areas with high prevalence of intravenous drug use. In the era of highly active antiretroviral therapy (HAART), life expectancy of these patients has increased and end-stage liver disease is a common cause of death. MATERIAL AND METHODS: This study included 387 HIV-positive patients treated at the Institute of Infectious and Tropical Diseases "Dr. Kosta Todorović" in Belgrade. We investigated epidemiological and clinical features of patients who underwent biochemical liver tests, ultrasonography and some of them blind liver biopsies. RESULTS: The prevalence of HCV infection among these patients was 58.13% with 225/387 ELISA anti-HCV-antibody positive patients. HCV coinfection was statistically more significant among male patients aged between 30 and 34, and among intravenous drug users. None of the biochemical parameters were statistically significant among coinfected patients, except aminotraspherase levels which were significantly higher among patients with chronic hepatitis C and HIV. 44 patients underwent biopsy and pathohistological findings showed that every 4th patient (25%) had chronic hepatitis C infection. The average survival rate in coinfected patients in the pre HAART era was the same as in AIDS patients. CONCLUSIONS: Liver biopsy, elevated aminotraspherase and positive serology can help in making the diagnosis of chronic hepatitis C, and possible future treatment options.