Seroepidemiology of HCV-HIV coinfection in Tunisia.

AIM: To determine the prevalence of antibodies to hepatitis C virus (HCV) in a cohort of patients infected with human immunodeficiency virus 1 (HIV-1) and to compare risk factors. METHODS: Multicenter retrospective study from infectious diseases department in Tunisia. We examined sera from HIV patients followed in these centers. Diagnosis of HCV infection was based on third generation enzyme-linked immunosorbent assay (ELISA) test. RESULTS: 362 HIV-1 patients were included in the study. The mean age was 35,5 years. 272 patients (75.13%) were male. Sexual transmission of HIV was the main risk factor (56.3%). 144 patients (39.7%) had antibodies against HCV, mainly in patients with history of intravenous drug abuse (78.4%). Quantitative evaluation of hepatitis C virus RNA was done only in 3 patients. CONCLUSION: HCV-HIV coinfection in tunisian patients occurs frequently, due to the same ways of transmission. More studies are needed to focus on sexual transmission of hepatitis C virus in order to prevent such infections rather than interferon-based therapies.

[Relapse of visceral leishmaniasis in HIV infection. Benefit of amphotericin B]. / Rechute de leishmaniose viscerale au cours de l'infection par le VIH interet de l'amphotericine B.

The reference treatment in visceral leishmaniasis is administration of antimonial compounds. Failures have been reported particularly in HIV-positive patients. The authors describe the case of a 40-year-old patient who, after 2 courses of N-methyl-glucamine, relapsed. Bone marrow cultures became negative only after adminstration of amphotericin B (1 mg x kg x d) for 28 days. He is still asymptomatic 18 months after he was cured. Amphotericin B, in case of relapse, seems to be a valuable alternative, until the availability of the liposomal form in our country.