Cambios en la prevalencia y distribución genotípica de la coinfección por el virus de la hepatitis C en pacientes infectados por el virus de la inmunodeficiencia humana / Prevalence and genotype distribution changes in hepatitis C virus co-infection among human immunodeficiency virus-infected patients

INTRODUCCIÓN: La prevalencia de hepatitis C es menor en los nuevos casos de pacientes infectados por VIH en España. El uso creciente del tratamiento frente al VHC podría haber cambiado la distribución genotípica del VHC. El objetivo de este estudio fue analizar los cambios en la prevalencia de la coinfección por VHC y en la distribución genotípica del VHC en pacientes infectados por VIH. Métodos Estudio de prevalencia seriada. Se incluyeron todos los pacientes infectados por VIH que acudieron a las consultas de un hospital de Andalucía entre septiembre de 2008 y febrero de 2009 (primer periodo) y entre enero y junio de 2013 (segundo periodo).Resultados Se incluyeron 520 y 651 pacientes en el primer y segundo periodos, respectivamente. El factor de riesgo de infección por VHC en el primer y segundo periodo fue: UDVP 319 (61%) vs. 348 (53%); contacto heterosexual, 111 (21%) vs. 135 (21%); homosexual, 76 (15%) vs. 114 (22%) (p = 0,006). La prevalencia de anti-VHC por periodos fue del 69% vs. el 58% (p=<0,001), y la de ARN-VHC detectable fue 49% vs. 37% (p=<0,001). En ambos periodos, la distribución genotípica fue: 1, 137 (60%) vs. 138 (59%); 3, 45 (20%) vs. 42 (18%); 4, 42 (18%) vs. 47 (20%) (p = 0,881). CONCLUSIONES: La prevalencia de infección por el VHC ha disminuido en los pacientes infectados por VIH en nuestro medio, incluyendo tanto la exposición al virus como la infección activa, en los últimos 5 años. Sin embargo, la distribución de los genotipos del VHC no ha cambiado

BACKGROUND: The prevalence of hepatitisC is decreasing among new diagnoses of HIV/HCV coinfection in Spain. The increasing use of the HCV treatment could have changed the HCV genotype distribution. The aim of this study is to analyze changes in the prevalence of HCV coinfection and in HCV genotype distribution among HIV-infected patients. METHODS: A serial cross-sectional study was conducted that included all HIV-infected patients who attended the Outpatient Clinic of a hospital in Andalusia, between September 2008 and February 2009 (first period), and between January 2013 and June 2013 (second period). RESULTS: A total of 520 and 651 patients were included in the first and second period, respectively. The risk factors of HCV infection in the first vs. second period were: IDU, 319 (61%) vs. 348 (53%); heterosexual contact, 111 (21%) vs. 135 (21%); homosexual men, 76 (15%) vs. 114 (22%) (P=.006). The prevalence of HCV antibody per period was: 358 (69%) vs. 380 (58%) (P=<.001), and for the HCV-RNA was 255 (49%) vs. 240 (37%) (P=<.001). In both periods, the HCV genotype distribution was: 1, 137 (60%) vs. 138 (59%); 3, 45 (20%) vs. 42 (18%); 4, 42 (18%) vs. 47 (20%) (P=.881). CONCLUSIONS: The prevalence of HCV infection in HIV-infected patients has decreased in our area, including overall exposure to HCV virus and active infection during the last 5 years. However, the HCV genotype distribution has not changed

[Prevalence and genotype distribution changes in hepatitis C virus co-infection among human immunodeficiency virus-infected patients]. / Cambios en la prevalencia y distribución genotípica de la coinfección por el virus de la hepatitis C en pacientes infectados por el virus de la inmunodeficiencia humana.

BACKGROUND: The prevalence of hepatitisC is decreasing among new diagnoses of HIV/HCV coinfection in Spain. The increasing use of the HCV treatment could have changed the HCV genotype distribution. The aim of this study is to analyze changes in the prevalence of HCV coinfection and in HCV genotype distribution among HIV-infected patients. METHODS: A serial cross-sectional study was conducted that included all HIV-infected patients who attended the Outpatient Clinic of a hospital in Andalusia, between September 2008 and February 2009 (first period), and between January 2013 and June 2013 (second period). RESULTS: A total of 520 and 651 patients were included in the first and second period, respectively. The risk factors of HCV infection in the first vs. second period were: IDU, 319 (61%) vs. 348 (53%); heterosexual contact, 111 (21%) vs. 135 (21%); homosexual men, 76 (15%) vs. 114 (22%) (P=.006). The prevalence of HCV antibody per period was: 358 (69%) vs. 380 (58%) (P=<.001), and for the HCV-RNA was 255 (49%) vs. 240 (37%) (P=<.001). In both periods, the HCV genotype distribution was: 1, 137 (60%) vs. 138 (59%); 3, 45 (20%) vs. 42 (18%); 4, 42 (18%) vs. 47 (20%) (P=.881). CONCLUSIONS: The prevalence of HCV infection in HIV-infected patients has decreased in our area, including overall exposure to HCV virus and active infection during the last 5 years. However, the HCV genotype distribution has not changed.