期刊
JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
卷 41, 期 1, 页码 31-36出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/01.qai.0000191281.77954.27
关键词
acute hepatitis C; HIV; pegylated interferon; men who have sex with men
资金
- NIAID NIH HHS [P30 AI027763, K24 AI051982, K24-AI51982] Funding Source: Medline
- NIDDK NIH HHS [P30 DK026743, P30 DK26743] Funding Source: Medline
- NIMH NIH HHS [T32 MH019105, T32 MH-19105] Funding Source: Medline
- NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES [K24AI051982, P30AI027763] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES [P30DK026743] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF MENTAL HEALTH [T32MH019105] Funding Source: NIH RePORTER
Hepatitis C virus (HCV) has become a significant source of morbidity and mortality in HIV-infected patients. However, little is known about the clinical presentation and course of acute HCV infection in this population. This study reports the outcomes of acute HCV infection in 9 HIV-infected men. Sex with men was the only reported risk factor for HCV infection in 6 of the subjects. Clinical presentation of acute HCV ranged from incidentally discovered elevated transaminases to severe liver dysfunction requiring hospitalization. At the time of HCV diagnosis, 8 of 9 patients had CD4(+) counts > 250 cells/mm(3), and 6 had HIV vital loads of <= 5000 copies/mL. Eight patients were receiving antiretroviral therapy. outcome of these acute HCV infections varied. Five patients experienced virologic clearance, 2 in whom virus cleared spontaneously and 3 who were treated with pegylated interferon and ribavirin. Four patients developed chronic infection, one of whom had a relapse during HCV treatment and 3 of whom Were untreated. All 4 patients to whom HCV therapy was administered experienced significant anemia or neutropenia, necessitating close reduction or Support with growth factors. Prompt recognition of acute HCV infection May minimize antiretroviral treatment interruption and will allow early treatment, which may improve virologic clearance. Unexplained transaminase elevations in HIV-infected patients, including men who have sex with men, should trigger an evaluation for acute HCV infection.
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