Avanzi Valéria Miranda, Vicente Bianca Arão, Beloto Nayara Carvalho Polido, Gomes-da-Silva Monica Maria, Ribeiro Clea Elisa Lopes, Tuon Felipe Francisco, Vidal Luine Rosele Renaud, Nogueira Meri Bordignon, Raboni Sonia Mara
Programa de Pós Graduação em Medicina Interna, Universidade Federal do Paraná, Curitiba, PR, Brasil.
Departamento de Doenças Infecciosas, Universidade Federal do Paraná, Curitiba, PR, Brasil.
Rev Soc Bras Med Trop. 2017 Jul-Aug;50(4):470-477. doi: 10.1590/0037-8682-0450-2016.
: HIV and viral hepatitis infections are major causes of chronic disease worldwide and have some similarities with regard to routes of transmission, epidemiology, front barriers faced during access of treatment, and strategies for a global public health response. The objective was to describe the HIV-1 subtypes, viral tropism and single-nucleotide polymorphisms (SNPs) of interleukin 28B (IL28B) from a case series of HIV/viral hepatitis coinfected patients from southern Brazil.
: Clinical and epidemiological data were evaluated by a review of medical records. Periodic blood draws were taken to determine the viral and host characteristics.
: This study included 38 patients with HIV/HBV or HIV/HCV coinfection; the median age was 49 years. Thirty-seven (97.4%) were on antiretroviral therapy, 32 (84.2%) had an undetectable viral load, a median CD4+ T-cell count of 452 cells/mm3. HIV-1 subtyping showed 47.4 and 31.6% of patients with subtypes C and B, respectively. Analysis of viral co-receptor usage showed a predominance of the R5 variant (64.7%), with no significant difference between the subtypes. Twenty patients with HIV/HCV coinfection were eligible to receive HCV therapy with pegylated-interferon-alpha plus ribavirin, and 10/20 (50%) of them achieved sustained virological response. SNPs of IL28B were evaluated in 93.3% of patients with HIV/HCV coinfection, and 17 (60.7%) presented the CC genotype.
: In the present case series, a higher frequency of HIV subtype C was found in coinfected patients. However such findings need to be prospectively evaluated with the inclusion of data from regional multicenter analyses.
HIV和病毒性肝炎感染是全球慢性病的主要病因，在传播途径、流行病学、治疗获取过程中面临的前沿障碍以及全球公共卫生应对策略方面存在一些相似之处。目的是描述巴西南部一系列HIV/病毒性肝炎合并感染患者的HIV-1亚型、病毒嗜性和白细胞介素28B（IL28B）的单核苷酸多态性（SNP）。
通过查阅病历评估临床和流行病学数据。定期采血以确定病毒和宿主特征。
本研究纳入38例HIV/HBV或HIV/HCV合并感染患者；中位年龄为49岁。37例（97.4%）接受抗逆转录病毒治疗，32例（84.2%）病毒载量不可检测，CD4+T细胞计数中位数为452个细胞/mm³。HIV-1亚型分析显示，分别有47.4%和31.6%的患者感染C型和B型。病毒共受体使用情况分析显示R5变体占主导（64.7%），各亚型之间无显著差异。20例HIV/HCV合并感染患者有资格接受聚乙二醇化干扰素-α加利巴韦林的HCV治疗，其中10/20例（50%）实现持续病毒学应答。93.3%的HIV/HCV合并感染患者评估了IL28B的SNP，17例（60.7%）呈现CC基因型。
在本病例系列中，合并感染患者中HIV C型的频率较高。然而，这些发现需要纳入区域多中心分析的数据进行前瞻性评估。
