11/21. Psychiatric barriers to readiness for treatment for hepatitis c Virus (HCV) infection among injection drug users: clinical experience of an addiction psychiatrist in the hiv-HCV coinfection clinic of a public health hospital.Among injection drug users, psychological and psychiatric barriers to readiness for treatment for hepatitis c virus (HCV) infection include mood and anxiety disorders, cognitive deficits, temperament disorders, and personality vulnerabilities, as well as ongoing drug use. Many aspects of these barriers can be overcome with direct treatment or social support. To establish effective treatment for HCV infection in this population of patients, it is essential that the patient and providers develop a rapport that allows for active communication. It is also important that the patient make an effort to adhere to the treatment requirements and that the patient receive the appropriate evaluation and management of treatable barriers.- - - - - - - - - - ranking = 1keywords = coinfection (Clic here for more details about this article) |
12/21. Severe CNS side-effect and persistent high efavirenz plasma levels in a patient with hiv/HCV coinfection and liver cirrhosis.We describe an hiv/HCV coinfected patient with liver cirrhosis, who experienced severe CNS side-effects during efavirenz-based hiv therapy. plasma levels of efavirenz were 10 times the upper limit and remained elevated (at twice the upper limit) 4 weeks after cessation of therapy. Efavirenz resistance (K103N) developed and was probably due to 'functional' monotherapy.- - - - - - - - - - ranking = 1keywords = coinfection (Clic here for more details about this article) |
13/21. 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 = 1keywords = coinfection (Clic here for more details about this article) |
14/21. 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 = 1.25keywords = coinfection (Clic here for more details about this article) |
15/21. Utilization of a liver allograft from a hepatitis B surface antigen positive donor.With today's donor organ shortage, enhanced efforts must be made to utilize organs that previously would have been declined. We report a 26-year-old man with chronic hepatitis b virus (HBV) and hepatitis c virus (HCV) coinfection who received a liver transplant from an HBsAg-positive donor. HBV viremia (6,281,185 copies/ml) was seen early posttransplant despite lamivudine prophylaxis, but became negative with addition of adefovir. Virologic analysis revealed predominantly donor HBV strain immediately posttransplant. At 5 months there was an elevation of liver enzymes accompanied by histologic evidence of hepatitis. At this time, HCV-rna was positive but HBV dna was undetectable. Treatment with pegylated interferon and ribavirin resulted in sustained clearance of HCV rna. Two years posttransplant, the patient has normal liver biochemistry and HCV and HBV viral load are undetectable with persistence of HBsAg. Our experience suggests that with effective antiviral therapy, the use of HBsAg seropositive donors is feasible in selected circumstances.- - - - - - - - - - ranking = 0.25keywords = coinfection (Clic here for more details about this article) |
16/21. Resolution of HCV infection after highly active antiretroviral therapy in a hiv-HCV coinfected patient.The effect of HAART on HCV infection and HCV-rna plasma levels is controversial. We describe a patient with hiv-HCV coinfection with persistent disappearance of HCV-rna after immunological and virological response to HAART, and we briefly discuss similar cases reported in the literature.- - - - - - - - - - ranking = 0.25keywords = coinfection (Clic here for more details about this article) |
17/21. Fetal ascites and second trimester maternal hepatitis c virus infection.OBJECTIVE: To present the first reported case of early second trimester maternal hepatitis c virus (HCV) associated with fetal ascites, which was treated with fetal paracentesis, and resulted in a successful outcome of a term liveborn infant with anti-HCV seropositivity. CASE REPORT: A 26-year-old primigravida woman was diagnosed with acute HCV infection at 17 weeks of gestation. Ultrasound (US) at 23 weeks showed significant fetal as cites and echogenic bowel, and fetal viral infection was suspected. Maternal serum was positive for high HCV-rna titers and cytomegalovirus (CMV) IgG. amniocentesis, cordocentesis and therapeutic fetal paracentesis were performed at 23 weeks. Fetal karyotype was 46, XX. Cord blood showed anti-HCV positivity and HCV-rna titer < 10. amniotic fluid was anti-HCV and CMV IgG positive. US at 27 weeks showed complete resolution of fetal ascites. A healthy 2,976 g female baby was delivered at 37 weeks, with anti-HCV seropositivity, high HCV-rna titers, CMV IgG positive, IgM negative and normal liver function tests at the 1-month follow-up. CONCLUSION: Second trimester perinatal HCV infection with possible CMV coinfection associated with fetal ascites is a rare event. Fetal therapy resulting in a successful outcome has not been reported. Prompt fetal therapy with paracentesis in this case led to the delivery of a healthy term liveborn baby with anti-HCV seropositivity.- - - - - - - - - - ranking = 0.25keywords = coinfection (Clic here for more details about this article) |
18/21. Severe chronic active hepatitis (autoimmune type) mimicked by coinfection of hepatitis c and human immunodeficiency viruses.Severe chronic active hepatitis, defined as the presence of a fivefold increase in serum aminotransferases and a twofold rise in gamma globulin for at least 10 weeks, is considered a progressive immunological liver disease requiring corticosteroid treatment, particularly when serum autoantibodies and a severe lymphoplasmacellular periportal infiltrate are found in the liver biopsy specimen. A 38 year old man who fulfilled the criteria for severe chronic active hepatitis is described. His sex, his homosexuality, and the presence of antibodies against hiv, however, led to the suspicion of a coinfection with hepatitis c virus (HCV) rather than autoimmune disease. The rapid and complete response to alpha interferon treatment and a recently available positive antibody test for HCV supported this view. These findings indicate that a HCV related chronic active hepatitis can present as the severe autoimmune type of chronic active hepatitis. Moreover, as in HBV infection, the response to treatment differs from that of autoimmune severe chronic active hepatitis.- - - - - - - - - - ranking = 1.25keywords = coinfection (Clic here for more details about this article) |
19/21. Mother-to-infant transmission of hepatitis c virus in human immunodeficiency virus-coinfected mother: a case report.We report a case of vertical transmission of HCV in a mother infected with both HCV and hiv. Our case suggests that coinfection with hiv, by causing an immune dysfunction, might be one of the risk factors for the transmission of HCV.- - - - - - - - - - ranking = 0.25keywords = coinfection (Clic here for more details about this article) |
20/21. Treatment of chronic hepatitis B and C with alpha interferon in a renal transplant patient.We report the case of a 51-year-old renal transplant patient, treated by interferon alpha (5MUI, three times a week) since he presented a coinfection by hepatitis B (HBV) and hepatitis c (HCV) virus for more than 7 years, associated with a chronic increase in serum alanine aminotransferase (ALT) levels and a chronic active hepatitis. The 4-month treatment was associated with a sustained normalization of ALT, a disappearance of HBV replication and a transient clearance of HCV viremia. Side effects were moderate and included thrombopenia (90,000/mm3), leucopenia (2200/mm3), an increase in serum creatinine (178 mumol/l). The withdrawal of alpha interferon was associated with the correction of these parameters. No rejection was observed on kidney biopsy. Meanwhile, liver histology was not affected by the treatment. To date, nineteen months after the end of alpha interferon therapy HBV dna was still negative; ALT remained normal despite the early recurrence of HCV viremia; this emphasized the fact that HBV infection was certainly the most important factor involved in the patient's chronic hepatitis. It is concluded that alpha interferon therapy is able to decline HBV replication for a prolonged period in renal transplant patient although its use should be performed with caution due to the potential renal side effects.- - - - - - - - - - ranking = 0.25keywords = coinfection (Clic here for more details about this article) |
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