Alexithymia in HIV, HCV and coinfections.

Recent studies show that alexithymia, an impairment of emotional processing, plays a role in HIV and HCV infections, although little is known about about alexithymia in HIV/HCV coinfection. This study aimed to assess alexithymia in patients suffering from HIV, HCV or HIV/HCV coinfection and observe major differences. We selected 153 subjects, excluding those with psychiatric diagnosis, cognitive impairment or opportunistic diseases, of whom 70 (46%) had HIV infection, 57 (37%) HCV infection and 26 (17%) HIV/HCV coinfection. For the evaluation of alexithymia, we used the Toronto Alexithymia Scale (TAS-20), a self-report questionnaire which allows the results to be assessed both on a dimensional level and on defined cutoff scores. Data analysis showed significant differences between monoinfected and coinfected subjects. The coinfected group had a mean score of 54.00 ±13.43, higher than HIV (48.11 ± 12.38) and HCV (48.28 ± 10.71) (p <0.05). Furthermore, we found clinically relevant scores (≥51) in 65.38% of coinfected subjects, in 42.85% of HIV and in 40.35% of HCV (p <0.05). Given the medical and behavioral correlates of alexithymia highlighted in the literature, we suggest that further investigations are needed to clarify the relationship between alexithymia and HIV/HCV coinfection.

Virological patterns of HCV patients with failure to interferon-free regimens.

The study characterized the virological patterns and the resistance-associated substitutions (RASs) in patients with failure to IFN-free regimens enrolled in the real-life setting. All 87 consecutive HCV patients with failed IFN-free regimens, observed at the laboratory of the University of Campania, were enrolled. All patients had been treated with DAA regimens according to the HCV genotype, international guidelines, and local availability. Sanger sequencing of NS3, NS5A, and NS5B regions was performed at failure by home-made protocols. Of the 87 patients enrolled, 13 (14.9%) showed a misclassified HCV genotype, probably causing DAA failure, 16 had been treated with a sub-optimal DAA regimen, 19 with a simeprevir-based regimen and 39 with an optimal DAA regimen. A major RAS was identified more frequently in the simeprevir regimen group (68.4%) and in the optimal regimen group (74.4%) than in the sub-optimal regimen group (56.3%). The prevalence of RASs in NS3 was similar in the three groups (30.8-57.9%), that in NS5A higher in the optimal regimen group (71.8%) than in the sub-optimal regimen group (12.5%, P < 0.0001) and in the simeprevir regimen group (31.6%, P < 0.0005), and that in NS5B low in all groups (0-25%). RASs in two or more HCV regions were more frequently identified in the optimal regimen group (46.6%) than in the simeprevir-based regimen group (31.6%) and sub-optimal regimen group (18.7%). In our real-life population the prevalence of RASs was high, especially in NS3 and NS5A and in those treated with suitable DAA regimens.