Loss of antibodies against hepatitis C virus in HIV-seropositive intravenous drug users

Chamot, Eric; Hirschel, B; Wintsch, Joëlle; Cf, Robert; Gabriel, Joseph M.; Jj, Déglon; Yerly, Sabine; Perrin, Luc

doi:10.1097/00002030-199012000-00016

Cited by 112 publications

(52 citation statements)

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“…With regard to our findings concerning ALT, other authors have also observed an association between positive anti-HCV test and elevated plasma ALT [20][21][22][23][24]. We consider that the cytopathic effect of HCV in the liver may be amplified when the patient is co-infected with HIV.…”

Section: Discussionsupporting

confidence: 68%

“…Some authors [19,20,21] consider that anti-HCV tests can present false positives in patients with HIV infection due to the high levels of circulating antibodies, while others argue that anti-HCV tests can give false negative results in cases of advanced AIDS because of decreased antibody production [22]. Some studies have shown a good correlation between the results of anti-HCV tests by EIA-2 and tests involving HCV RNA using the polymerase chain reaction (PCR); one such study showed that in groups with high risk for HCV infection about 93% of the positive anti-HCV EIA-2 tests were positive for the immunoblot test for HCV (RIBA-2), and 85% of them were HCV RNA positive [23][24].…”

Section: Discussionmentioning

confidence: 99%

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Viral hepatitis in patients infected with human immunodeficiency virus

Pavan¹,

Aoki²,

Monteiro³

et al. 2003

Braz J Infect Dis

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From 1992 to 1995 we studied 232 (69% male, 87% Caucasian) anti-human immunodeficiency virus (anti-HIV) positive Brazilian patients, through a questionnaire; HIV had been acquired sexually by 50%, from blood by 32%, sexually and/or from blood by 16.4% and by an unknown route by 1.7%. Intravenous drug use was reported by 29%; it was the most important risk factor for HIV transmission. The alanine aminotransferase quotient (qALT) was >1 for 40% of the patients, 93.6% had anti-hepatitis A virus antibody, 5.3% presented hepatitis B surface antigen, 44% were anti-hepatitis B core antigen positive and 53.8% were anti-hepatitis C virus (anti-HCV) positive. The anti-HCV test showed a significant association with qALT>1. Patients for whom the probable HIV transmission route was blood had a 10.8 times greater risk of being anti-HCV positive than patients infected by other routes. Among 30 patients submitted to liver biopsy, 18 presented chronic hepatitis. Key Words: Hepatitis C virus, human immunodeficiency virus, alanine aminotransferase quotient, anti-hepatitis A antibody, hepatitis B surface antigen, anti-hepatitis B core antigen (anti-HBc).

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Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Viral hepatitis in patients infected with human immunodeficiency virus

Pavan¹,

Aoki²,

Monteiro³

et al. 2003

Braz J Infect Dis

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“…32 In anti-HCV positive immunosuppressed patients, HCV RNA should be investigated, and its presence confi rms the diagnosis; however, a negative result does not exclude HCV infection, and, whenever suspicion is high, a new investigation should be performed in six months. 33,34 However, in some active HCV infections, HCV RNA cannot be detected.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of HIV/HCV coinfection in patients cared for at the Tropical Medicine Foundation of Amazonas

Victoria¹,

Victoria²,

Torres³

et al. 2010

Braz J Infect Dis

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We declare no confl ict of interest. ABSTRACTThe association of HIV infection and hepatitis C virus (HCV) infection often occurs because both viruses share the same transmission routes, increasing the possibility of HIV/HCV coinfection. World prevalence greater than 30% of coinfected cases is estimated, and it can reach 90% depending on the transmission route. With the aim of determining the frequency and profi le of HIV/HCV coinfected patients, a descriptive analysis was carried out with patients with HIV/AIDS whose serology was positive for hepatitis C virus (HCV), cared for at the Fundação de Medicina Tropical do Amazonas from 2000 to 2007. In the present study, of the 2,653 AIDS cases notifi ed in SINAN, 1,582 patients underwent serology test for hepatitis C, and a frequency of 4.42% (n = 70) of HIV/HCV coinfected patients was identifi ed in the period studied. The most frequent infection route was sexual transmission (84.3%), 68.6% among heterosexual individuals. Most patients were males (72.9%), aged between 25 and 40 years (60.1%), of low income (50% earning up to one minimum wage), and low educational level (80% had completed only middle school). A high percentage of deaths were observed during the study (34.3%). The results indicate a low seroprevalence of HIV/HCV coinfection in this population, in which sexual transmission, characterized by sexual promiscuity among heterosexual individuals, is the major transmission route of the virus rather than the use of injection drugs, as shown in world statistics.

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“…Since IDU are often coinfected with human immunodeficiency virus type 1 (HIV-1), it has been suggested that immunosuppression could explain the inability to mount and/or maintain an appropriate level of HTLV-2 antibodies, particularly in advanced stages of HIV disease (6). A similar poor antibody response has been described for hepatitis C virus in HIV-positive individuals, causing "occult" infections (2). Herein, we assess the impact of HIV-related immunosuppression on the performance of current serological tests used for HTLV-2 diagnosis.…”

mentioning

confidence: 96%

Can the Level of Immunosuppression in Human Immunodeficiency Virus-Infected Patients Affect the Reliability of Human T-Cell Lymphotropic Virus Type 2 Serological Diagnosis?

Bassani¹,

Toro²,

Jiménez³

et al. 2006

Clin Vaccine Immunol

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nosuppression, whereas PCR should be performed for subjects with a reactive HTLV EIA which is not further confirmed by WB.As with other retroviruses, the diagnosis of human T-cell lymphotropic virus type 1 (HTLV-1) or type 2 infections is generally made using serological assays that assess the presence of specific HTLV-1/2 antibodies. The recommended algorithm advises to first perform a screening enzyme immunoassay (EIA) to detect both viruses followed by Western blot (WB) testing of reactive samples to confirm infection and discriminate between HTLV-1 and HTLV-2. This approach is often accompanied by a high proportion of indeterminate WB results when low-risk populations, such as blood donors (1, 10), are tested, although subsequent PCR analyses discharge the presence of HTLV-1/2 infection in almost all cases. In contrast, in high-risk populations, such as intravenous drug users (IDU), indeterminate HTLV WB patterns or even nonreactive EIA results may be seen in persons with true HTLV-2 infection (6, 11). Since IDU are often coinfected with human immunodeficiency virus type 1 (HIV-1), it has been suggested that immunosuppression could explain the inability to mount and/or maintain an appropriate level of HTLV-2 antibodies, particularly in advanced stages of HIV disease (6). A similar poor antibody response has been described for hepatitis C virus in HIV-positive individuals, causing "occult" infections (2). Herein, we assess the impact of HIV-related immunosuppression on the performance of current serological tests used for HTLV-2 diagnosis.A large group of former IDU known to be HIV positive and on regular follow-up at our institution was analyzed. We have previously reported a high prevalence of HLTV-2 infection in this population (8). A total of 175 IDU had severe immunosuppression, with a CD4 cell count below 200 cells/l. They were matched by age, gender, and place of residence with 175 HIV-positive IDU with a preserved immune status and CD4 cell counts above 500 cells/l. Serum specimens were tested for antibodies to HTLV-1/2 using a commercial EIA (Murex HTLV IϩII; Abbott, Barcelona, Spain). Samples with repeated EIA reactivity were tested using a commercial WB (Bioblot HTLV; Genelabs, Singapore). These WB strips contain HTLV-1 viral lysate and three recombinant envelope proteins: the transmembranous HTLV gp21 (rgp21), the surface gp46 from HTLV-2 (rgp46-II), and the surface gp46 from HTLV-1 (rgp46-I). The HTLV European Research Network criteria (5) were used for interpreting WB patterns. Briefly, HTLV-2 positivity was considered when reactivity to at least two recombinant envelope bands (rgp21 and rgp46-II) and the gag band p24 was seen. HTLV-2 infection was considered negative when no bands appeared in the WB. Other WB patterns were interpreted as HTLV indeterminate.A specific HTLV-1/2 PCR was performed in all subjects with CD4 counts below 200 cells/l, as previously described elsewhere (9). Briefly, the HTLV-1/2 PCR was performed using nested primers (12P1, SK111, 12P5, 1P1, and 2P3) directed against th...

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Loss of antibodies against hepatitis C virus in HIV-seropositive intravenous drug users

Cited by 112 publications

References 0 publications

Viral hepatitis in patients infected with human immunodeficiency virus

Viral hepatitis in patients infected with human immunodeficiency virus

Epidemiology of HIV/HCV coinfection in patients cared for at the Tropical Medicine Foundation of Amazonas

Can the Level of Immunosuppression in Human Immunodeficiency Virus-Infected Patients Affect the Reliability of Human T-Cell Lymphotropic Virus Type 2 Serological Diagnosis?

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