Co-infecção vírus da imunodeficiência humana e vírus da hepatite C (HIV/HCV): aspectos epidemiológicos, clínicos e laboratoriais de uma população atendida em um serviço de hepatopatias na cidade de Belém-Pará

Abstract

The Human immunodeficiency virus 1 (HIV-1) and Hepatitis C virus (HCV) infection currently appears as co-morbidity, which can intervene mainly in natural history of hepatitis C. Describing demographic, clinical and laboratorial aspects including histopathological examination, was the objective of this study. Between august of 2004 to december of 2006, 36 co-infected patients were selected for this study. 92% were from Belém, with 42 years old medium age; 72.52% singles; 83.5% male and 61.1% heterosexuals. Among possible risk factors for HCV, 41, 7% referred injectable illicit drug use, 38,9% intranasal cocaine and 38,9% syringe share. History of alcoholism (77,8%) and TARV use had been the possible factors for hepatic illness aggravations. A patient showed clinical signals of hepatic failure from chronic disease. Among biochemical hepatic tests, medium ALT and AST levels had been 68UI/L and 61UI/L, respectively. T CD4+ lymphocytes medium levels were 327cells/mm3. Medium HIV viral load was 2,53 log10 copies/mL (ep=0,34). Medium HCV viral load was 5,90log10UI/mL. HCV genotype 1 was the most frequent (58,82%). 57% of the patients submitted to liver biopsy presented fibrosis ranging from moderate to severe and 11% did not presented fibrosis by METAVIR classification. There was association between T CD4+ lymphocytes and ALT or AST levels (p=0,0009 and p=0,0002), and there was association between HCV genotype 1 and HCV-RNA viral load higher or equal to 6 Log10 (p=0,34). There was association between HCV-RNA and HIV-RNA (p=0,039) viral load. The patients presented good health conditions, no signs of liver failure and immunological stability, but showed important liver structure alterations. Therefore, they are good candidates for HCV antiviral therapy. Perhaps, future studies using controlled group, having a large casuistry are necessary for better understanding of HIV/HCV co-infection.