Ramos Paesa C, Pascual Catalán A, Arazo Garcés P, Aguirre Errasti J M, Hermida Lazcano I
Servicio de Medicina Interna, Hospital Miguel Servet, Zaragoza.
An Med Interna. 1998 Sep;15(9):459-63.
To know the characteristics of the carriers of antibodies to hepatitis C virus (HCV) with persistently normal transaminases levels ("carriers") in coinfected with HIV, the incidence of the real viral activity and the factors that could determine it.
We analyzed 114 patients with criteria for chronic hepatitis C, 41 with detectable antibodies (anti-HCV), but without chemical evidence of a deteriorations of the liver function, all of them infected with HIV. In 6 patients was possible to determine the genotype of the HCV (INNO-LiPA HCV Innogenetics. Belgica) and in 32 the HCV-RNA (Amplicor HCV Roche Diagnostics). We compared the characteristics that could be differential between both groups, investigating the possible factors that could define the group of "carriers" with detectable viral activity.
From the 32 "carriers" in which we could determine the HCV-RNA, 15 (46.8%) had a positive result. The incidence of women in the "carriers" group was higher (41.4% vs 22.8%) (p < 0.05). The serum levels of gammaglobulin (gr/dl) was higher in the chronic hepatitis group (2.23 +/- 0.6 vs 1.9 +/- 0.5) (p < 0.01); however, these levels were higher for the 15 patients RNA (-) patients (2.19 +/- 0.7 vs 1.66 +/- 0.41) (p < 0.01). The genotype distribution of HCV found in the "carriers" group with detectable viremia was: genotype 1(5 patients), subtype la (3 patients), subtype lb (2 patients) an genotype 3 (3 patients). There was no significant difference with respect to age, sex, degree of immunosuppression or the length of the infection with HCV.
Approximately half of our "carriers" of anti-HCV without evidence of changes in the liver function, infected with HIV, show detectable viremia and so probably liver biopsy would be indicated. Women are more often "carriers" and the high levels of gammaglobulin could define the existence of a real viral activity.
