AID  Vol.3 No.2 , June 2013
HIV Prevalence among HCV Egyptian Infected Patients and Its Impact on the Result of HCV Treatment
Abstract: Background and Aim of the Study: HCV infection is the most common co-infection in HIV patients so we aimed to determine the prevalence of HIV infection in chronic HCV patients and its impact on chronic HCV patients treatment response. Patients and Methods: A retrospective study performed on 1852 chronic HCV patients subjected to anti HCV treatment with alpha 2a, alpha 2b or standard interferon and Ribavirin and tested and confirmed for HIV co infection by ELISA twice. Upon HIV testing, two groups were generated, Group 1: 1840 HCV patients, positive for HCV RNA, and Group 2: 12 HIV positive patients and positive also for HCV. Informed consents were obtained from patients. Proper hematological biochemical investigations and other causes of hepatitis rather than HCV were carried out and excluded. Results: The prevalence of HIV among HCV infected Egyptian patients was 0.64%. We found a male gender predominance; the hematological and biochemical parameters were similar in both groups with mild elevations in liver enzymes in group II. High rates of failure to treatment (77.8%) with lower SVR (22.2%) were in group II compared to group I (59.9%) as SVR was 22.1% in group II vs. 34.1% in group I, however with no statistical significance. Conclusion: Despite the lower prevalence of HIV in Egyptian patients with HCV infection, it still affects their response to treatment .Therefore; we must screen HIV in all HCV patients and recommend its test to routine investigations before starting HCV therapy.
Cite this paper: R. Fouad, O. Shaker, H. Hafez, R. Salama, M. Raziky, S. Marzouk, W. Akel, M. Ghany and G. Esmat, "HIV Prevalence among HCV Egyptian Infected Patients and Its Impact on the Result of HCV Treatment," Advances in Infectious Diseases, Vol. 3 No. 2, 2013, pp. 71-77. doi: 10.4236/aid.2013.32011.

[1]   B. D. Smith, R. L. Morgan, G. A. Beckett, Y. Falck-Ytter, et al., “Recommendations for the Identification of Chronic Hepatitis C Virus Infection among Persons Born during 1945-1965. Centers for Disease Control and Prevention,” The MMWR Recommendations and Reports, Vol. 61, RR-4, 2012, pp. 1-32.

[2]   F. El-Zanaty and A. Way, “Egypt Demographic and Health Survey 2008,” Ministry of Health, El-Zanaty and Associates, and Macro International, Egypt Demographic Health Survey, Cairo, Final Report, 2009, p. 431.

[3]   G. Esmat, A. M. Abouzied, F. Abdel-Aziz, et al., “Subjects with Chronic Hepatitis C and Genotype 4 Have a Similarly Effective Response to Standard or Pegylated Interferon in Combination with Ribavirin,” Hepatology, Vol. 38, 2005, pp. 324-331.

[4]   R. W. Lihana, D. Ssemwanga, A. Abimiku and N. Ndembi, “Update on HIV-1 Diversity in Africa: A Decade in Review,” AIDS Reviews, Vol. 14, No. 2, 2012, pp. 83-100.

[5]   UNAIDS, “UNAIDS Report on the Global AIDS,” Epidemic, 2009.

[6]   T. Y. Chen, E. L. Ding, G. R. Seage III, et al., “Meta-Analysis: Increased Mortality Associated with Hepatitis C in HIV-Infected Persons Is Unrelated to HIV Disease Progression,” Clinical Infectious Diseases, Vol. 49, No. 10, 2009, pp. 1605-1615. doi:10.1086/644771

[7]   B. H. McGovern, D. Thomas and P. A. L. Bonis, “Treatment of Hepatitis C Virus Infection in the HIV-Infected Patient,” Oxford Journals Medicine, Clinical Infectious Diseases, Vol. 41, Suppl. 1, 2011, pp. S56-S62.

[8]   P. Ward, M. Kugelmas and D. Libsch, “Management of Hepatitis C: Evaluating Suitability for Drug Therapy,” American Family Physician, Vol. 69, No. 6, 2004, pp. 1429-1436.

[9]   M. José, B. Pablo, R. Salvador, T. Paula, R. Violeta, V. Eugenia, L. Pablo, et al., “Rate and Timing of Hepatitis C Virus Relapse after a Successful Course of Pegylated Interferon plus Ribavirin,” Clinical Infectious Diseases, Vol. 49, No. 9, 2009, pp. 1397-1401. doi:10.1086/630205

[10]   M. G. Ghany, D. B. Strader, D. L. Thomas, et al., “American Association for the Study of Liver Diseases. Diagnosis, Management, and Treatment of Hepatitis C: An Update,” Hepatology, Vol. 49, No. 4, 2009, pp. 1335-1374. doi:10.1002/hep.22759

[11]   J. Macías, J. Berenguer, M. A. Japón, et al., “Fast Fibrosis Progression between Repeated Liver Biopsies in Patients co Infected with Human Immunodeficiency Virus/ Hepatitis C Virus,” Hepatology, Vol. 50, No. 4, 2009, pp. 1056-1061. doi:10.1002/hep.23136

[12]   M. Carbonero, V. Soriano, E. Valencia, et al., “Increasing Impact of Chronic Viral Hepatitis on Hospital Admissions and Mortality among HIV Infected Patients,” AIDS Research and Human Retroviruses, Vol. 17, No. 16, 2001, pp. 1467-1471. doi:10.1089/08892220152644160

[13]   Ministry of Health and Population, National AIDS Control Program, HIV/AIDS Prevention and Control in Egypt, 2007.

[14]   NAP, “The National AIDS Program, the Current AIDS Situation in Egypt,” 2008.

[15]   Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents, 2011. /HIVandAIDSActivities/ucm275877.htm

[16]   G. L. Armstrong, A. Wasley, E. P. Simard, G. M. Mc-Quillan, W. L. Kuhnert and M. J. Alter, “The Prevalence of Hepatitis C Virus Infection in the United States, 1999 through 2002,” Annals of Internal Medicine, Vol. 144, No. 10, 2006, pp. 705-714.

[17]   International AIDS Society-USA Panel, “Antiretroviral Treatment of Adult HIV Infection: 2010 Recommendations,” Jama, Vol. 304, No. 3, 2010, pp. 321-333.

[18]   CDC, “Centers for Disease Control and Prevention,” Hepatitis Surveillance Report, US Department of Health and Human Services, Atlanta, 2005. report.pdf.

[19]   S. Chopra, A. M. Di Bisceglie and A. C. Travis, “Predictors of a Sustained Virologic Response Following Treatment with Peg Interferon and Ribavirin for Chronic Hepatitis C Virus Infection,” Hepatology, Vol. 39, 2011, pp. 239-244.

[20]   A. Alberti, F. Noventa, L. Benvegnù, et al., “Prevalence of Liver Disease in a Population of Asymptomatic Persons with Hepatitis C Virus Infection,” Annals of Internal Medicine, Vol. 137, No. 12, 2002, pp. 961-974. doi:10.7326/0003-4819-137-12-200212170-00009

[21]   D. Ciuffreda, D. Comte, M. Cavassini, et al., “Polyfunctional HCV-Specific T-Cell Responses Are Associated with Effective Control of HCV Replication,” European Journal of Immunology, Vol. 38, No. 10, 2008, pp. 2665-2677. doi:10.1002/eji.200838336

[22]   M. Puoti, M. Bonacini, A. Spinetti, et al., “Liver Fibrosis Progression Is Related to CD4 Cell Depletion in Patients Coinfected with Hepatitis C Virus and Human Immunodeficiency Virus,” The Journal of Infectious Diseases, Vol. 183, No. 1, 2001, pp. 134-137.doi:10.1086/317644

[23]   J. P. Ong and Z. M. Younossi, “Managing the Hematologic Side Effects of Antiviral Therapy for Chronic Hepatitis C: Anemia, Neutropenia, and Thrombocytopenia,” Cleveland Clinic Journal of Medicine, Vol. 71, No. 3, 2004, pp. 17-21. doi:10.3949/ccjm.71.Suppl_3.S17

[24]   S. H. Mehta, A. Cox, D. R. Hoover, et al., “Protection against Persistence of Hepatitis C,” Lancet, Vol. 359, No. 9316, 2002, pp. 1478-1485. doi:10.1016/S0140-6736(02)08435-0

[25]   E. S. Daar, H. Lynn, S. Donfield, et al., “Relation between HIV-1 and Hepatitis C Viral Load in Patients with Hemophilia,” Journal of Acquired Immune Deficiency Syndromes, Vol. 26, No. 5, 2001, pp. 466-474.

[26]   C. L. Cooper and D. W. Cameron, “Effect of Alcohol Use and Highly Active Antiretroviral Therapy on Plasma Levels of Hepatitis C virus (HCV) in Patients co Infected with HIV and HCV,” Clinical Infectious Diseases, Vol. 41, No. 1, 2005, pp. S105-S109. doi:10.1086/429506

[27]   R. K. Sterling, J. A. Wegelin, P. G. Smith, et al., “Similar Progression of Fibrosis between HIV/HCV-Infected and HCV-Infected Patients: Analysis of Paired Liver Biopsy Samples,” Clinical Gastroenterology and Hepatology, Vol. 8, No. 12, 2010, pp. 1070-1079. doi:10.1016/j.cgh.2010.08.004

[28]   K. A. Kim, W. Lin, A. W. Tai, et al., “Hepatic SOCS3 Expression Is Strongly Associated with Non-Response to Therapy and Race in HCV and HCV/HIV Infection,” Journal of Hepatology, Vol. 50, No. 4, 2009, pp. 705-7011. doi:10.1016/j.jhep.2008.12.021

[29]   F. Carrat, F. Bani-Sadr, S. Pol, et al., “Pegylated Interferon Alfa-2b vs Standard Interferon Alfa-2b, plus Ribavirin, for Chronic Hepatitis C in HIV-Infected Patients: A Randomized Controlled Trial,” The Journal of the American Medical Association, Vol. 292, No. 23, 2004, pp. 2839-2848. doi:10.1001/jama.292.23.2839

[30]   N. J. Shire, J. A. Welge and K. E. Sherman, “Response Rates to Pegylated Interferon and Ribavirin in HCV/HIV Coinfection: A Research Synthesis,” Journal of Viral Hepatitis, Vol. 14, No. 4, 2007, pp. 239-245. doi:10.1111/j.1365-2893.2006.00824.x

[31]   H. Bardley, “Clinical Overview of HIV Disease in HIV in Site,” In: L. Peiperl, S. Coffey and P. Volberading, Eds., On-Line Textbook, 2006.

[32]   A. R. El-Zayadi, M. Attia, E. M. Barakat, H. M. Badran, H. Hamdy, A. El-Tawil, A. El-Nakeeb, O. Selim and A. Saied, “Response of Hepatitis C Genotype-4 Naive Patients to 24 Weeks of Peg-Interferon-Alpha2b/Ribavirin or Induction-Dose Interferon-Alpha2b/Ribavirin/Amantadine: A Non-Randomized Controlled Study,” The American Journal of Gastroenterology, Vol. 100, No. 11, 2005, pp. 2447-2452. doi:10.1111/j.1572-0241.2005.00253.x