1/18. Clearance of HCV rna in a chronic hepatitis c virus-infected patient during acute hepatitis b virus superinfection.The routes of hepatitis b virus and hepatitis c virus transmission are quite similar and coexistence of both viruses in one patient is not a rare phenomenon. Until now, the natural course of liver diseases induced by coinfections has not been well documented and the mechanisms of interaction between the two viruses and the human host have not been fully clarified. We report the case of a patient suffering from chronic hepatitis due to hepatitis c virus who developed an acute hepatitis b virus superinfection. serum hepatitis c virus ribonucleic acid became undetectable by reverse transcriptase/polymerase chain reaction at diagnosis of acute hepatitis b virus infection. At the same time, there was a striking increase in the serum concentrations of the antibodies against C22 and C33c hepatitis c virus antigens. Four months after clinical resolution of the acute hepatitis, hepatitis B surface antigen was undetectable in serum and three months later antibodies against hepatitis B surface antigen appeared. Two years after acute hepatitis b virus infection, the patient has had no relapse of markers for viral replication of hepatitis b virus. transaminases are within the reference range and hepatitis c virus ribonucleic acid is undetectable in both serum and liver tissue. We hypothesize that acute hepatitis b virus infection stimulated a specific humoral response against hepatitis c virus as well as triggering non-specific defense mechanisms which finally eliminated both viruses.- - - - - - - - - - ranking = 1keywords = coinfection (Clic here for more details about this article) |
2/18. HBV and HCV infection, polyarteritis nodosa and mixed cryoglobulinaemia: a case report.HCV infection has been associated with a broad spectrum of extrahepatic manifestations. In some of these, such as mixed cryoglobulinaemia (MC), the association is firmly established, whereas in others, such as polyarteritis nodosa (PAN), it is anecdotal; in fact, in this disorder the importance of the association is controversial, since it seems to be related to the frequent coinfection of HBV and HCV. The pathogenesis of MC and PAN is far from clear, but recent developments have added a plethora of information on the mechanisms underlying these disorders. Although both could be induced by a viral infection, the pathophysiological processes underlying the two diseases are different. We describe the occurrence in the same patient of HBV-related PAN and HCV-related MC.- - - - - - - - - - ranking = 1keywords = coinfection (Clic here for more details about this article) |
3/18. Severe hepatitis due to HBV-HDV coinfection.Quadruple hepatic infections are not uncommon in human immunodeficiency virus (hiv) infected patients. Hepatotropic viruses behave differently in immunocompromised patients resulting in varied clinical and serological outcomes. Delta hepatitis, an important cause of acute hepatitis in intravenous drug abusers (IVDAs) and hiv-infected patients, can present as coinfection or superinfection clinically, which influences the prognosis. Prevention of hepatitis d virus (HDV) coinfection is possible with hepatitis b virus (HBV) vaccination. No definitive medical treatment for HDV infection is known to be successful. Interestingly, liver transplantation carries a higher success rate in HDV/HBV infection then in HBV infection alone.- - - - - - - - - - ranking = 6keywords = coinfection (Clic here for more details about this article) |
4/18. Acute hepatitis B and C virus coinfection: a virological and clinical study of 3 cases.We report the virological interaction in, clinical presentation of, and course of disease observed in 3 male injection drug users with acute hepatitis b virus (HBV) and hepatitis c virus (HCV) coinfection. In all 3 cases, HBV infection presented first and quickly resolved. diagnosis of acute HBV/HCV coinfection requires a long follow-up period with careful observation.- - - - - - - - - - ranking = 6keywords = coinfection (Clic here for more details about this article) |
5/18. Initial low CD4 lymphocyte counts in recent human immunodeficiency virus infection and lack of association with identified coinfections.Initial CD4 lymphocyte counts were studied in 244 patients with human immunodeficiency virus (hiv) seroconversion. The CD4 cell counts at initial presentation after seroconversion were normally distributed (mean, 579/mm3; SD, 252). The mean percentage of CD4 cells was 26.1% (SD, 5.6). CD4 cell counts were < 500/mm3 in 41% and < 200/mm3 in 4%. The mean calculated duration of hiv infection was 7.7 months, which was not significantly different between the highest and lowest CD4 count quartiles (8.1 vs. 7.9). Age, sex, race, and serologic evidence of toxoplasmosis, cytomegalovirus, hepatitis B, syphilis, and varicella-zoster virus were not associated with initial low CD4 cell counts; however, never-married men were significantly overrepresented in the lowest quartile. These findings suggest that extensive CD4 lymphocyte depletion is common in early hiv infection and that frequent screening is necessary to identify newly infected patients who would benefit from antiretroviral therapy.- - - - - - - - - - ranking = 4keywords = coinfection (Clic here for more details about this article) |
6/18. Hepatocellular carcinoma in a patient with human immunodeficiency virus and hepatitis b virus coinfection: an emerging problem?Infections with hepatitis b virus (HBV) and human immunodeficiency virus (hiv) have similar risk factors and routes of transmission. It is estimated that 64 to 84% of hiv-infected individuals have positive markers for anti-HBc antibodies, with the chronic HBV infection rate approaching 16%. There is, however, a paucity of information on HBV/hiv coinfection, and its clinical implications remain unclear. We review the literature and report our recent experience with a 44-year-old man with HBV/hiv coinfection who developed metastatic hepatocellular carcinoma despite quiescent HBV and hiv disease courses. Highly active antiretroviral therapy has revolutionized hiv disease. As a result, morbidity and mortality from other underlying chronic, non-hiv-related diseases, such as the HBV infection and hepatocellular carcinoma reported here, will likely continue to increase in the hiv-infected patient population.- - - - - - - - - - ranking = 6keywords = coinfection (Clic here for more details about this article) |
7/18. Immune reconstitution hepatitis in hiv and hepatitis B coinfection, despite lamivudine therapy as part of HAART.hepatitis b virus (HBV) and human immunodeficiency virus (hiv) coinfection occurs commonly. The introduction of antiretroviral therapy can result in immune reconstitution hepatitis. We describe 2 coinfected patients who developed clinical flares of HBV disease, despite the inclusion of lamivudine, a drug with anti-HBV activity, in their HAART regimens. Potential strategies to manage individuals with HBV/hiv coinfection are discussed.- - - - - - - - - - ranking = 6keywords = coinfection (Clic here for more details about this article) |
8/18. Transplantation of hepatitis B surface antigen-positive livers into hepatitis b virus-positive recipients and the role of hepatitis delta coinfection.The scarcity of liver donors requires consideration of grafts from sources not previously used. allografts from hepatitis B surface antigen (HBsAg)-carriers without a significant liver disease have been proposed for liver transplant recipients with hepatitis b virus (HBV)-related cirrhosis and hepatocellular carcinoma (HCC). Combination prophylaxis schemes against HBV post-liver transplantation (LT) recurrence are currently available; the efficacy of those schemes in HBV-related cirrhosis and HCC must be assessed. This report describes the allocation of HBsAg-positive grafts in three HBsAg-positive recipients, with HBV-related cirrhosis and evolving HCC lesions, two of them with hepatitis Delta virus (HDV) coinfection. patients were administered anti-hepatitis B immunoglobulins (HBIGs) and lamivudine in order to prevent HBV recurrence. In spite of anti-HBV prophylaxis, HBV infection did persist after LT in all patients (no serum clearance of HBsAg). HBV replication assessed by serum HBV deoxyribonucleic acid (dna) presence was detected in the first month after LT in the 3 recipients. A prompt HDV reinfection with a clinical and histological pattern of hepatitis was observed in the 2 HBV / HDV coinfected recipients. In 1 of them, an evolving chronic hepatitis required a second LT. The non-HDV-infected patient showed an uneventful follow-up, but the lack of the neutralizing effect of HBIGs and the high risk of escape mutants forced the addition of adefovir-dipivoxil to lamivudine, in order to prevent viral variants and hepatitis recurrence. In conclusion, allografts from HBsAg-positive donors in HBsAg-positive recipients are associated with the persistence of the HBsAg after LT due to the failure of HBIG prophylaxis, even if lamivudine does inhibit virion production. This condition favors HDV replication and HDV hepatitis recurrence in coinfected patients. The allocation of HBsAg-positive grafts in HBsAg-positive recipients could be justified only in recipients without HDV coinfection and a combined prophylaxis with lamivudine and adefovir-dipivoxil is currently the best way to manage escape mutants in these recipients.- - - - - - - - - - ranking = 6keywords = coinfection (Clic here for more details about this article) |
9/18. Double hepatitis b virus infection in a patient with hiv/hepatitis c virus coinfection and 'anti-HBc alone' as serological pattern.Reported here is a case of double hepatitis b virus (HBV) infection in an hiv/hepatitis c virus (HCV)-coinfected patient with antibodies against hepatitis B core antigen as the only serological marker (anti-HBc alone). Two different HBV genotypes were identified in this patient. A search of the medical literature indicated this report is the first to describe a multiple silent HBV infection in an hiv/HCV-coinfected-patient. The elevated incidence of the anti-HBc alone pattern in hiv-positive patients and the increasing number of silent HBV infections detected in those patients demonstrate the need to carefully examine hiv-positive patients for occult HBV infection. In addition, it appears necessary to thoroughly study such patients in order to evaluate the impact of mixed HBV infection and triple hiv/HCV/HBV infection on morbidity.- - - - - - - - - - ranking = 4keywords = coinfection (Clic here for more details about this article) |
10/18. Acute coinfection with hepatitis B and hepatitis c viruses.Acute coinfection of hepatitis b virus (HBV) and hepatitis c virus (HCV) is rare. The few previously reported cases all describe acute HBV followed by acute HCV, leading to HBV clearance but chronic HCV. This is the first reported case of acute concurrent infection and spontaneous clearance of both HBV and HCV.- - - - - - - - - - ranking = 5keywords = coinfection (Clic here for more details about this article) |
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