Background of study: Chronic hepatitis C (CHC ) is common in HIV-infected patiens mainly among those who acquired the infection parenterally, such as intravenous drug users (IVDUs). The efficacy of therapy againts hepatitis C virus (HCV) infection in HIV-infected patients without severe immunodeficiency is similar to that obtained in patients not coinfected with HIV. On the other hand, HCV genotype is a crucial predictive factor of response to treatment in CHC. HCV genotypes is not uniformly distributed in the worl., there are differences between geographical regions, sometimes related to epidemiological factors such as the predominant transmision route. There are few data on genotype 4 HCV infection in European countries. Genotype 4
HCV is mostly transmitted by intravenous drug addiction, is associated with a low prevalence and the response to interferon alpha alone appears to be weak, as for HCV genotype 1.
Objective: To characterise the genotype 4 HCV prevalence among CHC IVDs patients with and withouth HIV infection. Desing The genotype and subtype of the HCV was studied by line probe assay (INNO-LiPA HCV II, Innogenetics, Belgium) in 123 IVDUs patients positives for HCV RNA and histological diagnosed of CHC. There were 95 males and 28 females with a mean age of 34.7 years (range 28-45).Sixty-two of them were coinfected with HIV.
Results: Infection by HCV genotype 4 was detected in 17 patients with anti-HIV antibodies (27.86%) and in 7 without HIV infection (11.29%).When prevalences of HCV genotype 4 were compared, significant differences were found between IVDUs with and without HIV infection ( p< 0.05 by Chi-square test with Yate´s correction). No significant effect of age, sex, CHC status and HCV viral load was observed between HCV genotype 4 positive patients with and without HIV infection.
Conclusion: In contrast to previous reports this study also showed a high prevalence of genotype 4 (around 30%) in European IVDUs with HIV infection. This study also confirm that treatment of CHC in HIV-positive IVDUs patients should consider HCV typing before beginning therapy.
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