STUDY REGARDING THE INCIDENCE OF CO - INFECTION HIV-HCV HEPATITIS INFECTIONS
Abstract:
Hepatitis B virus (HBV) and hepatitis C virus (HCV) are responsible for approximately 550-600 million illnesses. Although they belong to different virus families (the Hepadnaviridae family, respectively Flaviviridae), they still have in common the capacity to invade and multiply into the lymphatic system; they are essentially noncytopatogen; they are able to determine chronic hepatic infections, alone or in association with other kinds of viruses that may also have chronic evolution. Therapy for chronic hepatitis arouse a very large interest, especially within the last few years, being associated with a variable virusological response rate, related to the resistance to treatment, a particular situation being considered as hepatitis viruses and HIV coinfection. The prevalence of the HBV is estimated to 10% of HIV infected patients. In endemic affected countries, the ratio is much higher (Southeast Asia, Subsaharian Africa). The hepatitis C (HCV) and HIV viruses association is related to the way the coinfection is transmitted, especially by intravenous drugs injection and by homosexual relations. The coinfection’s recognition is made by using serological methods: the persistence of the VHB for more than 6 months confirms the chronic hepatitis, while the key-marker for C hepatitis is represented by the persistence of ARN-HCV in serum. The treatment for HIV infection decreases dramatically the risk of opportunist infections. On the other hand, in hepatitis viruses’ coinfection it doesn’t happen the same, due to an important ARV drug hepatotoxicity. This is the reason for which in these cases, the chronic hepatitis is the main cause of morbidity and mortality. The most hepatotoxic anti HIV agents are the non-nucleozidic inhibitors of reverse transcriptase (RT )- Nevirapin, in particular. On the other hand, the nucleozidic analogues (except didanosin ddI and d4T) have a low level of hepatotoxicity. The protease inhibitors boosted with ritonavir are not as toxic as complete ritonavir doses.
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