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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hepatitis C virus (HCV)/HIV coinfection is a burgeoning epidemic that received considerable attention at the 12th World AIDS Conference. Risk factors, transmission, coinfection and disease progression, treatment options, and the side effects of hepatitis B virus (HBV)/HCV coinfection are discussed. Among the findings are that HCV appears to help HIV progress faster, that highly active antiretroviral therapy (HAART) may even contribute to more rapid HCV infection of coinfected patients, and that an undetectable viral load does not influence HCV replication in HCV/HIV coinfection. Further, HAART appears to not have long-term beneficial effects on HCV viremia. Chronic active hepatitis and cirrhosis are the most relevant complications of long-term HIV survivors with HCV/HIV coinfection, a condition that will be more prevalent as patients survive longer.
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PMID:Hepatitis C virus (HCV) and HIV coinfection. 1136 99

Coinfection with hepatitis C virus (HCV) and HIV-1 is common in patients with hemophilia and in intravenous drug users. Little, however, is known about the relation between HIV-1 and HCV coinfection and the effects on HCV clearance and pathogenesis. We examined data from 207 HIV-1-infected and 126 HIV-1-uninfected patients with hemophilia enrolled in the multicenter Hemophilia Growth and Development Study. Participants were observed during prospective follow-up for approximately 7 years with annual measurements of alanine aminotransferase (ALT), CD4+ cells, and HCV and HIV-1 RNA levels. Clearance of HCV was more likely to occur in those uninfected with HIV-1 (14.3 versus 2.5%; odds ratio [OR] 4.79; 95% confidence interval [CI], 1.63-14.08, p =.005) and was more common with decreasing age (OR, 1.23; 95% CI, 1.04-1.47; p =.017). HCV RNA levels were higher throughout the 7 years of follow-up in those HIV-1-infected (p <.001). In the HIV-1-infected participants, baseline CD4+ cells were inversely related to HCV RNA with every 100-cell increase associated with a 0.19 log10 copy/ml decrease in HCV RNA (p =.002), and HIV-1 and HCV RNA levels were directly related (p =.008). Increasing HCV RNA levels were also associated with significantly higher ALT levels regardless of HIV-1 infection status. These results demonstrate that HIV-1/HCV co-infection is associated with a reduced likelihood of HCV clearance and that higher levels of HCV RNA are associated with increased hepatic inflammation.
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PMID:Relation between HIV-1 and hepatitis C viral load in patients with hemophilia. 1139 Nov 67

Hepatitis C virus (HCV) has emerged as a major pathogen among patients with human immunodeficiency virus (HIV). Morbidity and mortality were compared among 263 patients with HIV alone, 166 patients with HIV and HCV, and 60 patients with HCV alone (mean duration of follow-up, 2 years and 10 months). No differences in HIV loads and CD4 cells counts were observed between the HIV and HIV/HCV groups. Alanine aminotransferase levels were higher (52 U/L versus 35 U/L; P<.05) and albumin levels were lower (3.5 g/dL versus 3.8 g/dL; P <.02) among coinfected patients than they were among patients with HIV alone. Liver decompensation developed in 10% of patients with HIV/HCV coinfection. In contrast, no liver-related deaths or decompensation occurred in patients without coinfection (P<.05). Of the patients with HIV alone, 7% died, compared with 11% of the coinfected patients (P<.02); 47% of the deaths in the latter group were due to liver-related causes. In summary, HCV infection causes increased morbidity and mortality in patients with HIV infection.
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PMID:Hepatitis C virus infection-related morbidity and mortality among patients with human immunodeficiency virus infection. 1141 85

Many Hepatitis C (HCV) infected patients are coinfected with HIV. As HIV-directed anti-viral therapy has delayed HIV progression and mortality, pathologic consequences of HCV infection are occurring at an increased rate. In this review, a case presentation delineating the clinical course of an HIV/HCV coinfected patient at our institution is presented. The pathobiology, interrelation of HCV and HIV infection in coinfected patients is discussed as well as the effect of treatment in this unique patient population. The interaction of HIV and HCV coinfection is complex. It is clear that HIV infection negatively affects the natural history of HCV, while HIV-directed therapy may enhance immunologic response and exacerbate hepatocellular injury induced by HCV. Further studies assessing the effect of anti-HIV and anti-HCV-directed therapy on the clinical course of HCV/HIV coinfected patients is warranted.
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PMID:The effect of HIV coinfection on hepatitis C: A review. 1178 58

Hepatitis C virus (HCV) infection is an important problem in individuals who are also infected with HIV. HCV infection is very common in HIV-infected individuals, occurring in approximately one quarter to one third of this group, presumably as a consequence of shared routes of transmission related to virologic and pathogenic aspects of the viral infections. Although both are single-stranded RNA viruses and share similar epidemiologic properties, there are many important differences. Although the quantity of HIV RNA in plasma is an important prognostic determinant of HIV infection, this has not been shown with HCV. A direct relationship is apparent between HIV-related destruction of CD4 cells and the clinical consequences of the disease resulting from immunodeficiency. The pathogenesis of HCV, which occurs as a consequence of hepatic fibrosis, is much more complex. The hepatic stellate cell, the major producer of the extracellular matrix protein, is the main contributor to hepatic fibrosis, but the mechanism by which HCV induces hepatic fibrosis remains unclear. Treatment of HCV is increasingly important in HIV-infected patients due to improved HIV-associated morbidity and mortality and due to the frequency with which HCV occurs in patients with HIV-HCV coinfection. Timing of treatment initiation, management of side effects, and possible effects of anti-HCV therapy on HIV are among the issues that need consideration. Also, because several issues concerning HCV are unique to coinfected patients, further research is needed to determine optimal management of HCV in this setting.
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PMID:The HCV and HIV coinfected patient: what have we learned about pathophysiology? 1182 37

The southeastern region of Yunnan province is a key site for drug trafficking and HIV-1 infection spread from the west of Yunnan and Laos to southeastern China. To investigate the prevalence of HIV-1 infection and hepatitis C virus (HCV) coinfection among injection drug users (IDUs) in southeastern Yunnan, three cohorts of 285 addicts, including 242 IDUs and 43 oral drug users, living in the cities of Gejiu and Kaiyuan and the county of Yanshan were studied. HIV-1 and HCV infections were detected by enzyme-linked immunosorbent assay and/or polymerase chain reaction. Data on the age, sex, risk behavior, drug use history, employment, ethnic background, and marriage status were obtained by interview. The overall prevalence of HIV-1 infection was 71.9%. The rate of HCV coinfection among 138 HIV-1-infected IDUs was 99.3%. Most HIV-infected IDUs were 20 to 35 years old (86.7%) and were ethnic Han (75.9%), suggesting that the epidemic in Yunnan is no longer confined to non-Han ethnic minorities. HIV prevalence in female IDUs (81.2%) was significantly higher than in male IDUs (68.2%) ( p <.05). The prevalence of HIV infection reached 68.4% after 1 year of injection drug use. Needle/syringe sharing is the major high risk factor for the spread of HIV-1 and HCV infections. Large-scale educational campaigns are urgently needed to reduce the spread of HIV and HCV infection in these regions.
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PMID:High prevalence of HIV-1 and hepatitis C virus coinfection among injection drug users in the southeastern region of Yunnan, China. 1183 91

Both human immunodeficiency virus type 1 (HIV-1) and hepatitis C virus (HCV) lead to chronic infection in a high percentage of persons, and an expanding epidemic of HIV-1-HCV coinfection has recently been identified. These individuals provide an opportunity for simultaneous assessment of immune responses to two viral infections associated with chronic plasma viremia. In this study we analyzed the breadth and magnitude of the CD8(+)- and CD4(+)-T-lymphocyte responses in 22 individuals infected with both HIV-1 and HCV. A CD8(+)-T-lymphocyte response against HIV-1 was readily detected in all subjects over a broad range of viral loads. In marked contrast, HCV-specific CD8(+)-T-lymphocyte responses were rarely detected, despite viral loads in plasma that were on average 1,000-fold higher. The few HCV-specific responses that were observed were relatively weak and limited in breadth. CD4-proliferative responses against HIV-1 were detected in about half of the coinfected subjects tested, but no proliferative response against any HCV protein was found in these coinfected persons. These data demonstrate a major discordance in immune responses to two persistent RNA viruses. In addition, they show a consistent and profound impairment in cellular immune responses to HCV compared to HIV-1 in HIV-1-HCV-coinfected persons.
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PMID:Human immunodeficiency virus type 1-hepatitis C virus coinfection: intraindividual comparison of cellular immune responses against two persistent viruses. 1186 49

Coinfection with HIV accelerates the progression of hepatitis C toward advanced liver disease. Low CD4+ cell counts may result in false-negative results on all diagnostic tests except hepatitis C virus (HCV) RNA assays, which are the gold standard for viral replication. First-line management of HIV-HCV--coinfected patients should be optimization of HAART, because low CD4+ cell counts have been associated with greater fibrosis. In addition, agents used to treat hepatitis C may lower CD4+ cell counts and hemoglobin levels. Long-acting interferons offer the promise of better sustained HCV response in HIV-HCV coinfection.
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PMID:Management issues in patients coinfected with hepatitis C virus and HIV. 1186 56

Hepatic steatosis is common in patients with chronic hepatitis C virus (HCV) infection. Epidemiologic studies have shown HCV-associated steatosis to correlate with both patient factors, such as obesity and viral factors, such as HCV genotype 3a. Furthermore, the degree of steatosis has been linked to the extent of hepatic fibrosis in several studies, implying that steatosis may be contributing to disease progression in chronic HCV infection. Whether the pathogenesis of HCV-associated steatosis is linked to oxidative damage non-specifically, to HCV viral properties, or to other factors remains unknown. This steatosis may play an important role in the response to HCV therapy, in disease progression after liver transplantation for HCV, or in HIV-HCV coinfection.
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PMID:Hepatitis C and steatosis. 1194 33

HIV/HCV coinfection is characterized by a progredient course of hepatitis C. A more rapid development to cirrhosis, and especially in the presence of progredient immunodeficiency, an increased mortality due to liver failure has been described in coinfected patients. In addition hepatitis C has an unfavorable impact on the progression of HIV. The worse course of hepatitis C in HIV-coinfected patients as well as the faster progression of HIV underline the need for development of treatment options for hepatitis C in HIV-coinfected patients. First results from trials looking at the effect of pegylated interferon and ribavirin for treatment of hepatitis C in HIV-coinfected patients found primary response rates of around 50% which were clearly better than the response rates observed under non-modified interferon/ribavirin therapy in HIV/HCV-coinfected patients so far.
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PMID:[Hepatitis C and HIV coinfection. Current aspects of therapy]. 1204 70


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