Seroprevalence of HCV markers among HIV infected patients from Curitiba and metropolitan region

Tizzot, Maria Regina; Grisbach, Caroline; Beltrame, Marcia Holsbach; Messias-Reason, Iara José de Taborda

doi:10.1590/1806-9282.62.01.65

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ORIGINAL ARTICLES • Rev. Assoc. Med. Bras. 62 (1) • Jan-Feb 2016 • https://doi.org/10.1590/1806-9282.62.01.65 copy

Seroprevalence of HCV markers among HIV infected patients from Curitiba and metropolitan region

Soroprevalência de marcadores do vírus da hepatite C (HCV) em pacientes infectados com HIV de Curitiba e Região Metropolitana

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

Objective:

to determine the prevalence and epidemiological factors associated with hepatitis (HCV) coinfection in human immunodeficiency virus (HIV) patients from Curitiba and the metropolitan region.

Methods:

a study with 303 HIV+ patients, mean age 41.2 years (18-73); 50.5% men, followed at the Hospital de Clínicas, Universidade Federal do Paraná, between April 2008 and March 2009. Clinical and epidemiological data were obtained through questionnaires and retrospective analysis of medical records. Anti-HCV antibodies were detected by chemiluminescence immunoassay.

Results:

a total of 12.9% of HIV+ patients were positive for anti-HCV antibodies, 64.1% were men and 35.9% women, with mean age of 44.5 years (24-66). The frequency of HCV among men was 16.7% and among women 9.1% (p=0.06). HCV prevalence was associated to HIV infection when compared to the general population (p<10^-6, OR=100.4; 95CI=13.7-734.9). The parenteral route of transmission was the most frequent among coinfected patients (46.1%), and the sexual transmission among HIV+/HCV- (71.8%) (p=0.02, OR=0.2; 95CI=0.1-0.7). The frequency of intravenous drug users was higher among the coinfected patients (61.5%) compared to the non coinfected (12.6%) (p<10^-6, OR=11.1; 95CI=4.5-27.7).

Conclusion:

the prevalence of coinfection with HCV in HIV+ patients is 12.9%, 88 times higher than in the general population in Curitiba. The most frequent route of transmission in the coinfected patients is parenteral, but the sexual route is also representative (34.6%).

Keywords:
HIV; acquired immunodeficiency syndrome; coinfection; hepatitis C

	HIV n=264 (%)	HIV/HCV n=39 (%)	p	OR (CI95%)
Descent			n.s. ²
Euro-Brazilians	252(95,5)	37(94,9)
Afro-Brazilians	12 (4.5)	2 (5.1)
Gender			n.s. ²
Female	139 (52.7)	14 (35.9)
Male	125 (47.3)	25 (64.1)
Age
Mean (±SD3)	40.7 (±11.0)	44.5 (±11.4)	n.s. ²
Median (min-max)	39.4 (18-73)	41.7 (24-66)
Progression time			n.s. ²
< 2 years	131 (49.6)	13 (33.3)
2-5 years	45 (17.0)	11 (28.2)
6-10 years	33 (12.5)	6 (15.4)
≥ 10 years	6 (2.3)	0 (0)
N.I.¹ 1 Not informed.	49 (18.6)	9 (23.1)
Risk group			0.02	0.21 (0.06-0.71)
Sexual	120 (45.4)	9 (23.1)
Sexual/parenteral⁴ 4 The parenteral route includes patients who reported receiving transfusions and/or being drug users.	14 (5.3)	5 (12.8)
Parenteral⁴ 4 The parenteral route includes patients who reported receiving transfusions and/or being drug users.	33 (12.5)	12 (30.8)
N.I.¹ 1 Not informed.	97 (36.7)	13 (33.3)
Transmission routes			0.01	0.27 (0.10-0.74)
1 route	152 (57.6)	19 (48.7)
2 routes	13 (4.9)	7 (17.9)
More than 2 routes	2 (0.8)	0 (0)
N.I.¹ 1 Not informed.	97 (36.7)	13 (33.3)
Risk group for IDU ⁵ 5 The risk group for IDU included patients who reported being injectable drug users, regardless of whether they reported other routes or not.			<10 ^-6	11.12 (4.46-27.72)
IDU	21 (7.9)	16 (41.0)
Non-IDU	146 (55.3)	10 (25.6)
N.I.¹ 1 Not informed.	97 (36.7)	13 (1.4)

Geographical regions	N	HCV-HIV prevalence (Anti-HCV)	References
Florianópolis, SC	99	53.8%	Treitinger et al., 1999³⁴34 Treitinger A, Spada C, Silva EL, Miranda AF, Oliveira OV, Silveira MV, et al. Prevalence of serologic markers of HBV and HCV Infection in HIV-1 Seropositive Patients in Florianópolis, Brazil. Braz J Infect Dis. 1999; 3(1):1-5.
São Paulo, SP	1,457	17.7%	Mendes-Corrêa et al., 2001⁴¹41 Mendes-Corrêa MC, Barone AA, Guastini C. Hepatitis C virus seroprevalence and risk factors among patients with HIV infection. Rev Inst Med Trop São Paulo. 2001; 43(1):15-9.
Rio de Janeiro, RJ	238	8.9%	Ferraz et al., 2002⁴²Ferraz GGS, Menezes JA, Gazineo JLD, Passoni LFC, Lessa MPM, Pinto PTA, et al. Prevalência de Infecção pelos vírus "B" e "C" da Hepatite (HBV e HCV) em pacientes com infecção pelo vírus B e C da Imunodeficiência Humana (HIV). Rev Médica HFSE. 2002; 36(1). Available at: http://www.hse.rj.saude.gov.br/profissional/revista/36/hepat.asp. http://www.hse.rj.saude.gov.br/profissio...
Campinas, SP	232	53.8%	Pavan et al., 2003³⁵35 Pavan MHP, Aoki FH, Monteiro DT, Gonçales NSL, Escanhoela CAF, Gonçales Júnior FL. Viral hepatitis in patients infected with human immunodeficiency virus. Braz J Infect Dis. 2003; 7(4):253-61.
Santos, SP	495	36.2%	Segurado et al., 2004²¹21 Segurado AC, Braga P, Etzel A, Cardoso MR. Hepatitis C virus coinfection in a cohort of HIV-infected individuals from Santos, Brazil: seroprevalence and associated factors. AIDS Patient Care STDS. 2004; 18(3):135-43.
Londrina, PR	784	21.0%	Morimoto et al., 2005²²22 Morimoto HK, Caterino-De-Araujo A, Morimoto AA, Reiche EM V, Ueda LT, Matsuo T, et al. Seroprevalence and risk factors for human T cell lymphotropic virus type 1 and 2 infection in human immunodeficiency virus-infected patients attending AIDS referral center health units in Londrina and other communities in Paraná, Brazil. AIDS Res Hum Retroviruses. 2005; 21(4):256-62.
Manaus, AM	704	5.0%	Braga et al., 2006²³23 Braga WSM, da Costa Castilho M, dos Santos IC, Moura MA, Segurado AC, et al. Low prevalence of hepatitis B virus, hepatitis D virus and hepatitis C virus among patients with human immunodeficiency virus or acquired immunodeficiency syndrome in the Brazilian Amazon basin. Rev Soc Bras Med Trop. 2006; 39(6):519-22.
Porto Alegre, RS	330	38.2%	Tovo et al., 2006²⁵25 Tovo CV, Santos DE, Mattos AZ, Almeida PRL, Mattos AA, Santos BR. Prevalência ambulatorial em um hospital geral de marcadores para hepatites B e C em pacientes com infecção pelo vírus da imunodeficiência humana. Arq Gastroenterol. 2006; 43(2):73-6.
Cuiabá, MT	1,008	10.9%	Mussi et al., 2007²⁶26 Mussi AD, Pereira RA, Corrêa e Silva VA, Martins RM, Souto FJ. Epidemiological aspects of hepatitis C virus infection among HIV-infected individuals in Mato Grosso State, Central Brazil. Acta Trop. 2007; 104(2-3):116-21.
Botucatu, SP	150	14.7%	Corvino et al., 2007⁴³43 Corvino SM, Henriques RMS, Grotto RMT, Pardini MIMC. Co-infecção HIV/HCV em pacientes de Botucatu e região. Rev Bras Epidemiol. 2007; 10(4):537-43.
Belo Horizonte, MG	824	9.2%	Carmo et al., 2008⁴⁴44 Carmo RA, Guimarães MD, Moura AS, Neiva AM, Versiani JB, Lima LV, et al. The influence of HCV coinfection on clinical, immunological and virological responses to HAART in HIV-patients. Braz J Infect Dis. 2008; 12(3):173-9.
Belo Horizonte, MG	300	15.7%	Rodrigues et al., 2008⁴⁵45 Rodrigues Mda C, Viotti JB, Braga RF, Lourenço LFS, Antunes CM, Lambertucci JR. HIV/HCV coinfection in Infectious Disease Units in Mozambique and Brazil: a comparative study. Rev Soc Bras Med Trop. 2008; 415():518.
Londrina, PR	778	21.0%	Reiche et al., 2008²⁹29 Reiche EMV, Bonametti AM, Morimoto HK, Morimoto AA, Wiechemann SL, Matsuo T, et al. Epidemiological, immunological and virological characteristics, and disease progression of HIV-1/HCV-co-infected patients from a southern Brazilian population. Int J Mol Med. 2008; 21(3):387-95.
São Paulo, SP	8,019	12.9%	Farias et al., 2008²⁸Farias N, Tancredi MV, Wolffenbüttel K, Tayra A. Characteristics from persons and factors associated to HIV-seropositivity at the São Paulo State testing & counseling sites, 2000 to 2007. Bol Epidemiológico Paulista. 2008; 5(60). Available at: http://www.cve.saude.sp.gov.br/agencia/bepa60_hiv.htm. http://www.cve.saude.sp.gov.br/agencia/b...
Recife, PE	343	4.1%	Carvalho et al., 2009⁴⁶46 Carvalho FH, Coêlho MR, Vilella Tde A, Silva JL, Melo HR. HIV/HCV coinfection at an university hospital in Recife, Brazil. Rev Saúde Pública. 2009; 43(1):133-9.
São Paulo, SP	2,024	16.7%	Mendes-Corrêa et al., 2010⁴⁰40 Mendes-Corrêa MC, Martins LG, Tenore S, Leite OH, Leite AG, Cavalcante AJ, et al. Barriers to treatment of hepatitis C in HIV/HCV coinfected adults in Brazil. Braz J Infect Dis. 2010; 14(3):237-41.
Santa Maria, RS	250	31.2%	Santos et al., 2010³⁰30 Santos KF, Vieira TB, Beck ST, Leal DBR. Alterações laboratoriais encontradas em indivíduos co-infectados pelo vírus da imunodeficiência humana (HIV) e pelo vírus da hepatite C (HCV). Rev Bras Análises Clínicas. 2010; 42(1):21-4.
CE	1,291	25.4%	Távora et al., 2013³²32 Távora LG, Hyppolito EB, Cruz JN, Portela NM, Pereira SM, Veras CM. Hepatitis B, C and HIV co-infections seroprevalence in a northeast Brazilian center. Arq Gastroenterol. 2013; 50(4):277-80.
Curitiba, PR	303	12.9%	Present study

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