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

Thrombocytopenia is an important and common hematological abnormality in patients with HIV-1/HCV coinfection. Splenomegaly is a frequent finding in these patients and usually causes hypersplenism and thrombocytopenia. We analyzed the clinical results of a minimal invasive treatment (splenic artery embolization) for thrombocytopenia secondary to hypersplenism and refractory to other therapies in two hemophiliac patients, HIV seropositive and with cirrhosis due to chronic HCV infection. The results suggest that splenic artery embolization is a safe, relatively atraumatic and effective method for the treatment of splenomegaly and hypersplenism in selected patients with HIV-1/HCV coinfection.
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PMID:[Splenic artery embolization for the treatment of hypersplenism in hemophilic, HIV-1 and HCV seropositive patients]. 1287 7

Mother-to-child transmission of hepatitis C virus can take place in utero, during labour or after birth. Rate of vertical transmission varies widely between surveys but is around 5-6%. Maternal risk factors which may condition perinatal transmission risk are HIV/HCV coinfection, drug use, viral load, viral genotype, type of delivery and breastfeeding. On the basis of recent data, we propose a step-wise follow-up for HCV seropositive mothers and their infants. This proposal might represent an important occasion to unify behaviors in different Obstetrics-Gynecology and Neonatology Units.
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PMID:Proposal of a step-wise follow-up for hepatitis C seropositive mothers and their infants. 1292 Sep 71

HIV and HCV share common transmission pathways, but HCV is more efficiently transmitted through blood than with sexual exposure. Thus HCV coinfection is frequent in HIV seropositives, mainly in those with history of injection drug use and/or transfusion. HIV coinfection increases HCV replication rate, the rate of HCV vertical transmission and accelerates the course of hepatitis C towards cirrhosis and hepatocellular carcinoma. The evidence of an effect of HCV on HIV disease progression is less convincing. The results of several studies suggest that HCV coinfection does not hasten the progression of HIV infection towards AIDS. However two recent studies showed that HCV coinfection is independently associated with a lower restoration of CD4 counts during combination antiretroviral treatment. However this finding should be confirmed by additional studies.
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PMID:HIV/HCV co-infection: natural history. 1451 13

Hepatitis C virus (HCV) infection occurs in about one-third of HIV-seropositive patients and in about 90% of HIV-positive drug abusers. After the introduction of highly active antiretroviral therapy (HAART) and the subsequent reduction in mortality from opportunistic infections, HCV-related liver failure has become a frequent cause of death in HIV-positive patients. In HIV-seropositive patients, the course of HCV infection is accelerated and there is evidence that HCV is an important factor for HIV progression. Consequently, it is important to establish the appropriate treatment for HCV infection in HIV-seropositive patients. This review examines the epidemiology, physiopathology, diagnostics and treatment of HIV/HCV coinfection with particular regard to the impact of HAART.
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PMID:HIV and hepatitis C virus: facts and controversies. 1456 47

Drug-induced liver injury (DILI) is the elevation of liver enzyme and/or bilirubin levels caused by the use of a medication or drug. In patients with human immunodeficiency virus (HIV) infection, some of these events may not be directly caused by medication. Acute viral hepatitis, reactivation of hepatitis B virus or hepatitis C virus (HCV) infection, and/or alcohol use may play roles. Elevated transaminase levels are a signal of liver injury, but most cases improve despite continuation of drug therapy. Approximately 33% of patients with HIV infection are coinfected with HCV. Patients with HIV or HCV infection are more prone to DILI, possibly because of impaired hepatocyte defense mechanisms. HCV coinfection is associated with a 2-10-fold chance of developing elevated transaminase levels during highly active antiretroviral therapy (HAART). Patients with HIV/HCV coinfection should not be denied HAART. Instead, they should be followed-up with monthly liver function tests and referred to specialists if grade 3 or 4 liver enzyme elevations occur.
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PMID:Liver injury during highly active antiretroviral therapy: the effect of hepatitis C coinfection. 1498 82

The natural history of hepatitis C virus (HCV) infection is altered by human immunodeficiency virus (HIV) coinfection. Plasma HCV RNA is higher in HIV-infected patients and may further increase as HIV immune deficiency progresses. Hepatic fibrosis and clinical features of hepatic dysfunction develop more rapidly in HIV/HCV coinfection than in HCV alone. Although HIV/HCV-coinfected patients may progress more rapidly to AIDS, other confounding variables include comorbidities, substance abuse, and social issues. Alcohol consumption accelerates both HCV and HIV disease. Given these interactions and the high prevalence of HIV/HCV coinfection, chronic HCV infection will greatly affect the morbidity, mortality, and medical management of HIV patients, and HIV will also affect the care of patients with HCV.
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PMID:Natural history of HIV and HCV coinfection. 1498 16

Due to shared risk factors for transmission, coinfection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) is a very common event. The prevalence of HCV infection among HIV-positive patients averages about 35% in the United States and Europe, but in clinical populations where there is a great prevalence of intravenous drug use as a risk factor for acquiring HIV, this value may be as high as 80-90%. Several studies have confirmed that HIV coinfection accelerates the natural course of chronic hepatitis C and an increased risk of liver cirrhosis, hepatocellular carcinoma, and decompensated liver disease has been found in coinfected subjects. Other studies have shown an increased risk of progression to acquired immunodeficiency syndrome (AIDS) and AIDS-related death among HIV-HCV-positive persons, suggesting that HCV coinfection may accelerate the course of HIV disease. In addition, hepatitis C may affect the management of HIV infection, increasing the incidence of liver toxicity associated with the antiretroviral regimens. The optimal therapeutic approach to HCV infection in HIV coinfected patients is still uncertain, because of the complex pathogenesis of both infections, potential drugdrug interactions, and the poor literature and information available about safety and efficacy of an interferon (IFN) and ribavirin combination in this clinical population. Available data show that the sustained virological response rates in coinfected persons treated with standard IFN plus ribavirin range from 18-40%, and several studies with pegylated IFN plus ribavirin are ongoing.
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PMID:Human immunodeficiency virus and hepatitis C virus coinfection: epidemiology, natural history, therapeutic options and clinical management. 1500 41

The declining incidence of AIDS-related opportunistic diseases among people with HIV infection has shifted the focus of clinical management to prevention and treatment of comorbidities such as chronic liver disease. The increased risk of hepatitis C virus (HCV)-related advanced liver disease in people with HIV infection makes early HCV diagnosis a priority. To assess HCV prevalence and predictors of HIV/HCV coinfection, we have conducted a retrospective analysis of people enrolled in the CAESAR (Canada, Australia, Europe, South Africa) study, a multinational randomized placebo-controlled study of the addition of lamivudine to background antiretroviral therapy. The impact of HCV on HIV disease progression was also examined. Anti-HCV antibody testing on 1649 CAESAR study participants demonstrated a HIV/HCV coinfection prevalence of 16.1%, which varied from 1.9% in South Africa to 48.6% in Italy. The strongest predictor of HIV/HCV coinfection was HIV exposure category (P<0.0001), with odds ratios (ORs) compared to homosexual as follows: injecting drug use (IDU), 365 [95% confidence interval (CI): 179-742]; transfusion or blood products, 32.2 (95% CI: 15.2-67.6); homosexual and IDU, 22.9 (95% CI: 8.5-62.1). The prevalence of HIV/HCV was low (3.7%) among homosexual men without reported IDU. Other predictors of HIV/HCV coinfection were alanine aminotransferase (ALT), country of residence, ethnicity and stage of HIV disease. A history of IDU or ALT > or =40 U/L at baseline had a positive predictive value (PPV) of 35%, negative predictive value (NPV) of 96%, sensitivity of 82% and specificity of 71% for HIV/HCV coinfection. HIV disease progression was similar in HIV monoinfected and HIV/HCV coinfected patients. People with HIV and a history of IDU or elevated liver function tests should be targeted for HCV testing. The low prevalence of HIV/HCV coinfection among homosexual men without a history of IDU suggests low efficiency of sexual HCV transmission.
HIV Med 2004 May
PMID:HIV and hepatitis C coinfection within the CAESAR study. 1513 84

Liver toxicity is a common side effect of antiretroviral therapy, particularly in subjects coinfected with the hepatitis C virus (HCV). The incidence of severe liver toxicity after initiation of treatment with lopinavir (LPV) as well as its possible association with LPV plasma levels were assessed in 120 HIV-infected patients (52% coinfected by HCV). The incidence of severe liver toxicity at 3 months was 1.7% and the cumulative incidence at 12 months was 4%. The development of severe liver toxicity was associated with HCV coinfection but not with LPV plasma levels.
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PMID:Short communication: liver toxicity of lopinavir-containing regimens in HIV-infected patients with or without hepatitis C coinfection. 1530 12

Hepatitis C virus (HCV) coinfection is common among individuals with HIV, and the progression of liver disease is accelerated in coinfected individuals compared with those with HCV alone. HCV coinfection also can decrease tolerability of highly active antiretroviral therapy. Additionally, the presence of HCV appears to increase morbidity and mortality in these individuals, and as such the management of both HCV and HIV in coinfected individuals requires careful consideration. Although coinfected patients should be considered for HCV therapy, the limited information to date indicates a lower rate of virologic response with current HCV therapies. Moreover, interactions between HCV and HIV antiviral medications may occur and potentially affect treatment efficacy. Thus, the decision to undertake HCV treatment must be individualized.
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PMID:Treatment of the hepatitis C virus in patients coinfected with HIV. 1532 39


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