1/6. 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) |
2/6. Hepatocellular carcinoma in hiv-infected patients with chronic hepatitis c.OBJECTIVES: Chronic hepatitis c is frequently seen in hiv-positive subjects infected through needle sharing or transfusion of contaminated blood products. Progression to end-stage liver disease seems to occur faster in these patients. As the life expectancy of hiv-infected persons has dramatically improved since the introduction of highly active antiretroviral therapies, cirrhosis and eventually hepatocellular carcinoma (HCC) may be recognized at an increasing rate in patients coinfected with hiv and hepatitis c virus (HCV). methods: We identified the main features of hiv-infected individuals with end-stage liver disease due to HCV infection and diagnosed with HCC in three hiv/AIDS referral centers, and compared these features to those of a control group of patients with HCV-related HCC but without hiv infection. RESULTS: Seven hiv-infected patients were identified. Of these, six were <45 yr of age and had been intravenous drug users. The mean time between exposure to HCV and the development of HCC was estimated to be 17.8 yr. Two subjects were coinfected with hepatitis B and delta viruses, respectively. Only one individual had been diagnosed of an AIDS-defining condition before the diagnosis of HCC was made. However, all subjects had < 500 CD4 T cells at the time of HCC diagnosis. Five died within the first 4 months of follow-up. patients in the control group (n = 31) were significantly older (68.9 /- 8.9 vs 42.2 /- 10.4; p < 0.001) and the duration of HCV infection was significantly longer (28.1 /- 10.9 vs 17.8 /- 2.7; p < 0.05) than in those with hiv-HCV coinfection. CONCLUSIONS: HCC seems to occur at a younger age and after a shorter period of HCV infection in subjects coinfected with hiv. Thus, treatment of CHC should be encouraged in hiv-positive patients, and in those with HCV-related cirrhosis the periodic monitoring of alpha-fetoprotein and abdominal ultrasonography should be recommended.- - - - - - - - - - ranking = 1keywords = coinfection (Clic here for more details about this article) |
3/6. polyarteritis nodosa and mixed cryoglobulinaemia related to hepatitis B and C virus coinfection.OBJECTIVE: To determine the responsibility of hepatitis b virus (HBV) and hepatitis c virus (HCV) and therapeutic implications in a patient who developed systemic vasculitis. CASE REPORT: The case of a 38 year old woman who had a past history of addiction to intravenous drugs and developed systemic vasculitis after infection by HBV and HCV is described. The clinical and laboratory findings substantiated not only the diagnosis of polyarteritis nodosa (PAN) but also that of mixed cryoglobulinaemia with a monoclonal IgMkappa component. CONCLUSION: Because cryoglobulins are rarely found in HBV related PAN but often associated with HCV infection, and in light of the histological findings, cryoglobulinaemia was interpreted as being secondary to HCV infection. This example of a highly complex situation emphasises the need to gather all relevant clinical, biological, histological, and complementary data so that the best treatment for overlapping of distinct vasculitides can be selected.- - - - - - - - - - ranking = 4keywords = coinfection (Clic here for more details about this article) |
4/6. Resolution of HCV infection in a hiv-infected patient under HAART after several hepatitis flare-ups.Highly active antiretroviral therapy (HAART) has been shown to have a beneficial effect on several opportunistic and other coinfections of hiv infected individuals. The effect of HAART on HCV coinfections is controversial. We describe the case of a patient, in whom a close temporal relationship between changes in hiv viremia, HCV viremia and ALT levels was observed. Longterm suppression of hiv replication by HAART was associated with a normalization of ALT levels and finally clearance of the HCV infection. Our data suggest that improved immune functions due to reductions of the hiv load led to a better control and finally resolution of the HCV infection in this patient.- - - - - - - - - - ranking = 2keywords = coinfection (Clic here for more details about this article) |
5/6. hiv Infection, hepatitis c infection, and HAART: hard clinical choices.Abnormalities in hepatic function have become one of the most common complications occurring among human immunodeficiency virus (hiv)-infected individuals receiving highly active antiretroviral therapy (HAART), and liver disease has become an increasingly important cause of morbidity and mortality in hiv-infected patients. We present a case of a patient with hiv infection and hepatotoxicity that exemplifies the complications currently observed during the treatment of such patients. Hepatotoxicity can be a result of several factors, including a direct effect of HAART, substance abuse, and coinfection with either hepatitis c virus (HCV) or hepatitis b virus. Imaging studies may be helpful in determining the etiology; however, a liver biopsy is often necessary to be able to more accurately determine the relative contributions of different processes. Although coinfection with HCV and hiv has become a common clinical problem, optimal treatment of such patients remains to be defined and must be individualized to maximize benefit and tolerance.- - - - - - - - - - ranking = 2keywords = coinfection (Clic here for more details about this article) |
6/6. hepatopulmonary syndrome in hiv-hepatitis c virus coinfection: a case report and review of the literature.A wide array of diagnoses must be considered when a patient with advanced liver disease and human immunodeficiency virus (hiv) infection presents with hypoxemia. It is important to entertain the possibility of hepatopulmonary syndrome (HPS) in such patients, a diagnosis that must be confirmed with a contrast-enhanced echocardiogram (bubble study). We describe a case of HPS diagnosed in a patient with hiv infection and chronic liver disease and review the literature on HPS.- - - - - - - - - - ranking = 4keywords = coinfection (Clic here for more details about this article) |