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. 2014 Nov-Dec;56(6):517-24.
doi: 10.1590/s0036-46652014000600011.

HIV and HCV coinfection: prevalence, associated factors and genotype characterization in the Midwest Region of Brazil

Solange Zacalusni Freitas  1 , Sheila Araújo Teles  2 , Paulo Cesar Lorenzo  1 , Marco Antonio Moreira Puga  1 , Tayana Serpa Ortiz Tanaka  1 , Danilo Yamamoto Thomaz  1 , Regina Maria Bringel Martins  2 , Angelita Fernandes Druzian  1 , Andréa Siqueira Campos Lindenberg  1 , Marina Sawada Torres  3 , Sérgio A Pereira  4 , Livia Melo Villar  4 , Elisabete Lampe  4 , Ana Rita Coimbra Motta-Castro  1
Affiliations

HIV and HCV coinfection: prevalence, associated factors and genotype characterization in the Midwest Region of Brazil

Solange Zacalusni Freitas et al. Rev Inst Med Trop Sao Paulo. 2014 Nov-Dec.

Abstract
in English, Portuguese

A cross-sectional study on prevalence, associated factors and genotype distribution of HCV infection was conducted among 848 HIV-infected patients recruited at reference centers in the Midwest Region of Brazil. The prevalence rate of HIV-HCV coinfection was 6.9% (95% CI: 5.2 to 8.6). In multivariable analysis, increasing age, use of illicit drugs (injection and non-injection), a history of blood transfusion before 1994, and the absence of a steady partnership were significant independent associated factors for HIV-HCV coinfection. The phylogenetic analysis based on the NS5B region revealed the presence of two major circulating genotypes of HCV: genotypes 1 (58.3%) and 3 (41.7%). The prevalence of HIV-HCV coinfection was lower than those reported in studies conducted with HIV-infected patients in different regions of Brazil, due to the fact that illicit drug use is not a frequent mode of HIV transmission in this region of Brazil. Serologic screening of HIV-patients for HCV before initiating antiretroviral treatment, a comprehensive identification of associated factors, and the implementation of effective harm reduction programs are highly recommended to provide useful information for treatment and to prevent HCV coinfection in these patients.

Estudo transversal sobre a prevalência, fatores associados e distribuição dos genótipos do HCV foi realizado em 848 pacientes infectados pelo HIV, recrutados em centros de referência na Região Centro-Oeste do Brasil. A taxa de prevalência de coinfecção HIV-HCV foi de 6,9% (IC 95%: 5,2-8,6). Na análise multivariada, o aumento da idade, o uso de drogas ilícitas (injetáveis e não injetáveis), história de transfusão de sangue antes de 1994, e ausência de companheiro constante foram fatores associados independentes e significativos para a coinfecção HIV-HCV. A análise filogenética baseada na região NS5B revelou a presença de dois principais genótipos do HCV em circulação: genótipos 1 (58,3%) e 3 (41,7%). A prevalência da coinfecção HIV-HCV foi menor do que as relatadas em estudos realizados com pacientes infectados pelo HIV em diferentes regiões do Brasil, devido ao fato de que o uso de drogas ilícitas não é modo frequente de transmissão do HIV neste Estado do Brasil. Triagem sorológica de pacientes HIV-positivos para HCV antes de iniciar o tratamento antirretroviral, identificação completa dos fatores associados e a implementação de programas eficazes de redução de danos são altamente recomendados para fornecer informações úteis, para o tratamento e para evitar a coinfecção com HCV nestes pacientes.

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Figures

Fig. 1
Fig. 1. Neighbor-Joining phylogenetic tree based on the HCV NS5B genome from 36 Brazilian HIV-HCV coinfected patients and 130 reference nucleotide sequences with different genotypes retrieved from GenBank. The Brazilian HCV isolates from HIV-HCV coinfected patients from this study are marked with a red circle and are interspersed with HCV subtypes 1a, 1b and 3a reference genes. The bootstrap support values over 75% (obtained for 1,000) replicates are shown next to the branches.
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