Be careful caring for coinfected HIV/AIDS patients with Hepatitis C

Liver damage in co-infection of Hepatitis-C-HIV is not diminished, although there is severe immunodeficiency.

The provision of highly active anti-retroviral drugs trigger a worsening of liver fibrosis, or a form of connective tissue that correlated with an increase CD4 cells in the liver cells.

This was revealed in court trials doctoral dissertation, Rino Alvani, SpPD-KGEH, on Monday (September 9, 2011) in the Senate Chamber, University of Indonesia, Faculty of Medicine, Indonesia.

Dr. Alvani, one of expert of liver disease in Indonesia presented a giving effect of Highly Active Antiretroviral Therapy in Patients with Heart Hepatology with Dual Infection of Hepatitis C Virus and Human Immunodeficiency Virus, and Cellular Immunity in Relation to the Liver Tissue.

According to Dr. Alvani, patients with co-infected hepatitis C-HIV with low immunity or CD4 below 200 must obtain antiretroviral therapy (ARV). The goal, antiretroviral drugs suppress the proliferation of HIV virus.

When the immune system increases, until the CD4 count reaches 200, the patient should be given treatment for hepatitis C.
This is to prevent the occurrence of damage such as worsening of fibrosis, or formation of connective tissue in the liver of patients.

He said, “The damage will occur, if the medicines are given only to HIV-AIDS alone. So please, in patients coinfected with both should be treated.”

The study included 48 patients with coinfected, and remain 34 patients in 48 weeks.
All patients have an average low CD4 (26.5 cells/uL). Before and after receive highly active antiretroviral therapy (HAART), patients are biopsied to determine whether there are necroinflammation and liver fibrosis.

According to the findings, biopsy before receiving HAART, there is mild necroinflammation (54.2%).
Second biopsy after received HAART, the score of necroinflammation did not change but fibrosis scorei increased significantly.
Increase in fibrosis score correlated with an increased number of CD4 cells in the liver cells.