Clinical and histological characteristics of HIV and hepatitis C virus-co-infected patients in Brazil: a case series study

Hepatitis C virus (HCV) is an important factor contributing to morbidity and mortality in patients co-infected with HIV and HCV. In addition, liver biopsy is an important tool in the clinical management of these patients. Although liver biopsy is controversial, it is recommended for all patients. Data regarding the clinical and histological characteristics of these patients are scarce not only in Brazil but in Latin America as a whole. With the goal of better understanding these characteristics and the benefit of liver biopsy indications in this disease setting, data collected from 234 patients followed from 1996 to 2004 at Casa da AIDS, São Paulo, were analyzed. The following variables were extracted from the patients' medical files at the time of liver biopsy: sex, age, hepatitis C infection risk factors, hepatitis C infection duration, ALT levels, CD4+ T cell counts, history of alcohol abuse, history of antiretroviral therapy, HCV genotype, and liver histological alterations. CONCLUSIONS: 1 - Hepatitis C virus 1 and 3 were the most frequently identified genotypes and were diagnosed in 72% and 25.5% of cases respectively; 2 - Structural liver alterations were found to be mild or absent in 48.2% (113/234) of the analyzed patients; 3 - Fifty-three patients (23%) had normal ALT levels and 4 - Significant liver architectural changes (F2-F3) were evident in 22.5% of the patients with normal ALT levels.

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Updating the Signal-to-cutoff Level to Reduce Anti-hepatitis C Virus False Positivity

Jundishapur Journal of Microbiology ◽

10.5812/jjm.119110 ◽

2021 ◽

Vol 14 (10) ◽

Author(s):

Servet Oztürk ◽

Canan Ağalar

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Area Under The Curve ◽

Hcv Rna ◽

Hepatitis C Infection ◽

False Positivity ◽

History Of ◽

Training And Research ◽

Polymerase Chain ◽

The Cost

Background: Anti-hepatitis C virus (anti-HCV) is the only screening test being used in the diagnosis of hepatitis C. In this study, we examined anti-HCV positivity rates in our hospital. Objectives: The aim of administering the anti-HCV test was to distinguish patients with hepatitis C infection from false positivity in patients with reactive results. Methods: The anti-HCV tests were performed at Fatih Sultan Mehmet Training and Research Hospital in Istanbul, Turkey, between January 1, 2015 and December 31, 2019. The patients were evaluated retrospectively in terms of age, gender, anti-HCV titer, the clinic for which the examination was requested, the reason for the examination, and the history of hepatitis C. Results: In this study, 511 patients who had two negative polymerase chain reaction (PCR) results were evaluated as false positive cases and enrolled. The cut-off value was found to be 7.5 IU/ml, with the highest sensitivity of 94.4% and specificity of 94.5% (area under the curve [AUC]: 0.982). The lowest anti-HCV titer (5.2) was from patients without acute hepatitis, who were HCV-RNA positive and diagnosed with chronic hepatitis C. Conclusions: It may be more appropriate to report anti-HCV cut-off value of 0 - 5 as negative, 5 - 7.5 as borderline, and > 7.5 as positive. Working with a more acceptable cut-off level with a greater number of tests can help identify patients with asymptomatic HCV infection. Also, it can possibly reduce the cost due to a decrease in the number of PCR tests administered.

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Ledipasvir and Sofosbuvir in the Treatment of Early Hepatitis C Virus Infection in HIV-Infected Men

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy238 ◽

2018 ◽

Vol 5 (10) ◽

Cited By ~ 5

Author(s):

Paari M Palaniswami ◽

Ahmed El Sayed ◽

Benjamin Asriel ◽

Jesse R Carollo ◽

Daniel S Fierer ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Drug Use ◽

Case Series ◽

Hcv Infection ◽

Duration Of Treatment ◽

Open Label ◽

Case Series Study ◽

Hcv Transmission ◽

Chronic Hcv

Abstract Background Treatment of HIV-infected men during early hepatitis C virus (HCV) infection with interferon results in a higher cure rate with a shorter duration of treatment than during chronic HCV infection. We recently demonstrated that this phenomenon applied to interferon-free treatment as well, curing most participants with short-course sofosbuvir and ribavirin. Due to the significantly higher potency of the ledipasvir/sofosbuvir (LDV/SOF) combination, we hypothesized that we would be more successful in curing early HCV infections using a shorter course of LDV/SOF than that used for treating chronic HCV infections. Methods We performed a prospective, open-label, consecutive case series study of 8 weeks of LDV/SOF in HIV-infected men with early genotype 1 HCV infection. The primary end point was aviremia at least 12 weeks after completion of treatment. Results We treated 25 HIV-infected men with early sexually acquired HCV infection with 8 weeks of LDV/SOF, and all 25 (100%) were cured. Twelve (48%) reported sexualized drug use with methamphetamine. Conclusions Eight weeks of LDV/SOF cured all 25 HIV-infected men with early HCV infection, including those who were actively using drugs. Based on these results, we recommend treatment of newly HCV-infected men during early infection, regardless of drug use, to both take advantage of this 8-week treatment and to decrease further HCV transmission among this group of men.

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Liver fibrosis progression in HIV/hepatitis C virus coinfected patients with normal aminotransferases levels

Revista da Sociedade Brasileira de Medicina Tropical ◽

10.1590/s0037-86822012000400005 ◽

2012 ◽

Vol 45 (4) ◽

pp. 444-447 ◽

Cited By ~ 2

Author(s):

Fábio Heleno de Lima Pace ◽

Lincoln Eduardo Vieira de Castro Ferreira ◽

Antonio Eduardo Benedito Silva ◽

Maria Lucia Gomes Ferraz

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Liver Fibrosis ◽

Liver Biopsy ◽

Hepatitis B Surface Antigen ◽

Hcv Rna ◽

Progression Rate ◽

Fibrosis Progression ◽

Normal Alanine Aminotransferase ◽

Normal Alt

INTRODUCTION: Approximately 30% of hepatitis C virus (HCV) monoinfected patients present persistently normal alanine aminotransferase (ALT) levels. Most of these patients have a slow progression of liver fibrosis. Studies have demonstrated the rate of liver fibrosis progression in hepatitis C virus-human immunodeficiency virus (HCV-HIV) coinfected patients is faster than in patients infected only by HCV. Few studies have evaluated the histological features of chronic hepatitis C in HIV-infected patients with normal ALT levels. METHODS: HCV-HIV coinfected patients (HCV-RNA and anti-HIV positive) with known time of HCV infection (intravenous drugs users) were selected. Patients with hepatitis B surface antigen (HBsAg) positive or hepatitis C treatment before liver biopsy were excluded. Patients were considered to have a normal ALT levels if they had at least 3 normal determinations in the previous 6 months prior to liver biopsy. All patients were submitted to liver biopsy and METAVIR scale was used. RESULTS: Of 50 studied patients 40 (80%) were males. All patients were treated with antiretroviral therapy. The ALT levels were normal in 13 (26%) patients. HCV-HIV co-infected patients with normal ALT levels had presented means of the liver fibrosis stages (0.77±0.44 versus 1.86±1.38; p<0.001) periportal inflammatory activity (0.62±0.77 versus 2.24±1.35; p<0.001) and liver fibrosis progression rate (0.058±0.043 fibrosis unit/year versus 0.118±0.102 fibrosis unit/year) significantly lower as compared to those with elevated ALT. CONCLUSIONS: HCV-HIV coinfected patients with persistently normal ALTs showed slower progression of liver fibrosis. In these patients the development of liver cirrhosis is improbable.

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Efficacy of Sofosbuvir and Daclatasvir in the Treatment of Chronic Hepatits C Viral Infection

10.53350/pjmhs2115123164 ◽

2021 ◽

Vol 15 (12) ◽

pp. 3164-3166

Author(s):

Mohammad Arif ◽

Shah Zaman ◽

Amir Zaman Khan ◽

Riaz Nasim

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Viral Infection ◽

Sustained Virological Response ◽

Chronic Hepatitis C ◽

Virological Response ◽

Combined Therapy ◽

Case Series ◽

Hepatitis C Infection ◽

Case Series Study

Aim: To know the efficacy of combined therapy with sofosbuvir and daclatasvir, in patients suffering from chronic hepatitis C viral infection in Khyber Pakhtunkhwa. Study Design: Descriptive case series study. Place and duration of study: Department of Gastroenterology, Hayatabad Medical Complex, Peshawar, Pakistan, from 1stOctober 2017 to 28th February 2019. Methodology: Ninety eight patients were suffering from chronic hepatitis C infection enrolled. All patients were treated with sofosbuvir 400 mg and daclatasvir 60 mg daily for a period of three to six months. Ribavirin was added to the treatment of patients where indicated. All patients were followed 24 weeks after completion of treatmentto know the outcome in terms of sustained virological response (SVR). Results: The mean age of patients was 42.16±11.65 years, with 43 males and 55 females. Fifty one patients that received sofosbuvir and daclatasvir, achieved SVR rate of 88.23% (45/51) while 47 patients who were given sofosbuvir, daclatasvir and ribavirin , achieved SVR rate of 89.36 % (42/47). Six months after completing 12 to 24 weeks of treatment, a follow up PCR was done. The SVR rate, 24 weeks post treatment was 88.77% (87/98). The most common side effects observed were generalized body aches 24%, fatigue 21%, headache 10% and fever 6%. Conclusion: Once daily oral daclatasvir 60mg combined with sofosbuvir 400mg, with or without ribavirin proved effective, with SVR rate of 88.77%, in patients infected with chronic hepatitis C viral infection. Keywords: Direct acting antiviral, Chronic hepatitis C, Sustained virological response, Ribavirin, Efficacy, Sofosbuvir,

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Insulin resistance raises the risk for recurrence of stage I hepatocellular carcinoma after curative radiofrequency ablation in hepatitis C virus-positive patients: A prospective, case series study

Hepatology Research ◽

10.1111/j.1872-034x.2009.00616.x ◽

2010 ◽

Vol 40 (4) ◽

pp. 376-382 ◽

Cited By ~ 30

Author(s):

Kenji Imai ◽

Koji Takai ◽

Yoichi Nishigaki ◽

Shogo Shimizu ◽

Takafumi Naiki ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Insulin Resistance ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Radiofrequency Ablation ◽

Case Series ◽

Stage I ◽

Case Series Study ◽

Prospective Case Series ◽

Series Study

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Epidemiological and Clinical Characteristics of Hepatitis C Viral Infections in Tertiary Centres in Sulaimani City / Kurdistan Region of Iraq

Kurdistan Journal of Applied Research ◽

10.24017/science.2017.2.4 ◽

2017 ◽

Vol 2 (2) ◽

pp. 29-35

Author(s):

Bestun Rahim Hama Rahim ◽

Ali Hattem Hussain ◽

Mohammed Omer Mohammed ◽

Kamal Jalal Rashid

Keyword(s):

Hepatitis C ◽

Viral Infections ◽

Case Series ◽

Signs And Symptoms ◽

Hcv Infection ◽

Hepatitis C Infection ◽

Face To Face ◽

Case Series Study ◽

Common Causes ◽

Genotype Test

Hepatitis C infection is one of the most common causes of chronic liver disease. It is growing threat and main burden on public health. Globally more than 170 million people are infected with hepatitis C virus (HCV), up to 4 million new infections annually and each year more than 350000 dies of HCV related complications, including cirrhosis and hepatocellular carcinoma (HCC). Thus this descriptive case-series study was conducted in five health facilities in Sulaimani city, from 23rd December 2015 to 10th of June 2016. The data were collected from 180 HCV infected patients by face to face interview; they were interviewed privately by using a structured questionnaire. P-values of ≤0.05 were considered statistically significant. Out of 180 patients, 45% were males and 55% were females, the mean age of the cases was 33.18 years, regarding marital status 55.5% of the cases were single. The majority of the cases were diagnosed by routine screening. Most of the patients (70.7%) had no signs and symptoms at the time of diagnosis. In each patient at least two identifiable risk factors for getting HCV infection were reported. Among the patients that had genotype test, 67.2% of them infected with genotyope1. More than three-quarters of the participants had elevated alanine aminotransferase (ALT) and aspartate aminotransferase (AST). More future studied parameters and practical skills should be performed to significantly reduce the risk of HCV infection in Sulaimani.

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Hepatitis C virus carriers with persistently normal ALT levels: biological peculiarities and update of the natural history of liver disease at 10 years

Journal of Viral Hepatitis ◽

10.1111/j.1365-2893.2005.00667.x ◽

2006 ◽

Vol 13 (5) ◽

pp. 290-296 ◽

Cited By ~ 37

Author(s):

M. Persico ◽

S. Perrotta ◽

E. Persico ◽

L. Terracciano ◽

A. Folgori ◽

...

Keyword(s):

Hepatitis C Virus ◽

Liver Disease ◽

Hepatitis C ◽

Natural History ◽

History Of ◽

Normal Alt

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Agreement in Pathologic Interpretation of Liver Biopsy Specimens in Posttransplant Hepatitis C Infection

Archives of Pathology & Laboratory Medicine ◽

10.5858/1999-123-0143-aipiol ◽

1999 ◽

Vol 123 (2) ◽

pp. 143-145

Author(s):

Zobair M. Younossi ◽

Navdeep Boparai ◽

Terry Gramlich ◽

John Goldblum ◽

Peggy George ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Liver Biopsy ◽

Chronic Hepatitis C ◽

The United States ◽

Intraobserver Agreement ◽

Hepatitis C Infection ◽

Biopsy Specimens

Abstract Hepatitis C virus–related disease is rapidly becoming the most common indication for orthotopic liver transplant (OLT) in the United States. Although post-OLT hepatitis C viremia is universal, 40% to 60% of patients develop recurrent chronic hepatitis C. Distinguishing recurrent chronic hepatitis C infection from acute rejection may be difficult because of overlapping histopathologic features. To improve our diagnostic accuracy we undertook a study to determine interobserver and intraobserver agreement between pathologists examining post-OLT liver biopsy specimens in patients from our transplant database. Clinical data and microscopic sections from 26 patients with hepatitis C virus–related OLT were reviewed. Biopsy specimens were obtained because of abnormal liver enzymes (21/26) or routine post-OLT follow-up (5/26), representing both early (18 ± 11 days) and late (252 ± 206 days) post-OLT periods. Unidentified sections were examined by an experienced pathologist in a randomly assigned order and reexamined 6 weeks later in the same fashion by the initial reviewer and a second experienced pathologist. Interobserver and intraobserver agreement was calculated using κ statistic. The intraobserver agreement was 81% with a κ coefficient of 0.67 (P = .001). The interobserver agreement was 78% with a κ coefficient of 0.60 (P < .001). The early post-OLT biopsy specimens (18 ± 11 days) were the most difficult to interpret.

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