Low prevalence of HCV co-infection in HIV/HBV co-infected teenagers from Romania
Abstract number: 1733_1391
Manolescu L., Sultana C., Marinescu P., Ruta S.
Objectives: In Romania there was the biggest paediatric HIV infection acquired by parenteral route. The prevalence of HBV markers at these children was of 78.3% at HIV infected versus 21.8% in HIV negative controls. The teenagers acquired HIV and HBV infection horizontally. This study was performed to examine the impact of HCV co infection in HIV/HBV co infected teenagers from Romania.
Methods: Two groups of patients with HIV infection, from different Romanian regions (161 from Constanta, 198 from Giurgiu), average age 13.8±1.3, were retrospectively analysed 2 years for clinical and virological parameters. Clinical liver function parameters (AST, ALT, total bilirubin, albumin), CD4 count, and virological parameters (HCV, HBV and HIV viral load by Roche Amplicor), HBsAg, HBeAg, HBsAb, HBcAb were performed twice a year.
Results: Prevalence of HCV antibodies was low and similar in both groups 2.04% respectively 2.5%. All HCV/HIV co infected patients were also HBV infected and treated with potent antiretroviral therapy (HAART), but never experienced specific antiviral anti HCV treatment. We noticed in both groups similar correlations. HBV/HCV/HIV co infection with active HBV replication revealed through the presence of HBeAg and DNA-HBV high titer (40.000.000 copies DNA-HBV/mL) in both groups: 33.3% respectively 40%, was associated with worsened HIV-related parameters (CD4 count under 100 cell/microL, average HIV titer above 750.000 copies RNA HIV/mL), and increased transaminase (average values 156 mg/dl) but undetectable HCV titers, compared to patients without active HBV replication that presented detectable HCV titers (average of 11550 copies RNA-HCV/mL) and undetectable HIV and HBV titers and transaminase. Patients co infected with HIV/HCV and without HBeAg appeared to have a good response to HAART in terms of CD4 count changes, with a CD4 count average of 532 cells/microL.
Conclusions: A surprisingly low prevalence of HCV co infection was found in HIV/HBV co infected patients despite the commune route of transmition. HIV disease outcomes following HAART do not appear to be adversely affected by HCV co infection and reveal good CD4 count responses. Active chronic HBV co infection in HCV/HIV co infected patients is associated with worsened liver disease and worsened HIV condition.
|Session name:||European Society of Clinical Microbiology and Infectious Diseases|
|Location:||ICC, Munich, Germany|
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