RESUMO
Our aim was to evaluate the killer cell immunoglobulin-like receptors (KIRs) as a marker for the development of thrombocytopenia secondary to Peg-interferon (IFN) therapy in a cohort of human immunodeficiency virus (HIV)/hepatitis C virus (HCV) co-infected patients. Patients were naive to HCV treatment, receiving a first course of Peg-IFN/Ribavirin combination therapy. Total platelet count (cells ml-1) was determined at each visit, determining platelet decline from baseline to weeks 1, 2, 4, 8 and 12 after starting therapy. The end point of the study was development of thrombocytopenia, defined as a platelet count of <1 50 000 cells ml-1. Fifty-eight HIV/HCV co-infected patients were included in the study, of whom 20 (34.4%) developed thrombocytopenia. The absence of KIR2DS2 was associated with higher and faster rate of thrombocytopenia (54.2% vs 22.5%; P=0.012; 6.6 vs 10.3 weeks; P=0.008). The absence of KIR2DS2 was associated with a greater decline in platelet count and development of thrombocytopenia during Peg-IFN treatment in HIV/HCV co-infected patients.
Assuntos
Interferon-alfa/uso terapêutico , Receptores KIR/metabolismo , Trombocitopenia/tratamento farmacológico , Trombocitopenia/metabolismo , Adulto , Antivirais/uso terapêutico , Coinfecção/tratamento farmacológico , Coinfecção/metabolismo , Quimioterapia Combinada/métodos , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/metabolismo , Hepacivirus/efeitos dos fármacos , Hepatite C Crônica/tratamento farmacológico , Hepatite C Crônica/metabolismo , Humanos , Masculino , Contagem de Plaquetas/métodos , Ribavirina/uso terapêuticoAssuntos
Infecções por HIV/tratamento farmacológico , Antígeno HLA-B18/genética , Hepatite C/tratamento farmacológico , Cirrose Hepática/genética , Coinfecção , Progressão da Doença , Genótipo , Infecções por HIV/complicações , Infecções por HIV/genética , Hepatite C/complicações , Hepatite C/genética , Humanos , Cirrose Hepática/etiologia , Cirrose Hepática/imunologia , Fatores de Risco , Análise de Sobrevida , Falha de TratamentoRESUMO
Our aim was to analyze the influence of HLA-B haplotypes on liver fibrosis progression in HIV/hepatitis C virus (HCV) co-infected patients. Retrospective longitudinal study including HIV/HCV, non-cirrhotic and HCV treatment-naïve patients. The main outcome variable was liver fibrosis progression of at least one stage. One hundred and four patients constituted the study population (F0-F1: 62 (59.6%); F2: 22 (21.2%); F3: 20 (19.2%)). During a median follow-up of 54.5 months (IQR: 26.2-77), 45 patients (43.3%) showed an increase in the stage of liver fibrosis (time to event: 29 (IQR: 14-49.5) months). HLA-B18pos patients more frequently had a higher and faster fibrosis progression rate (73.3%; 24 (IQR: 8-29) months) than HLA-B18neg patients (38.2%; 34.5 (IQR: 14.7-51.2) months). This association was also observed in the development of F3-F4 fibrosis among F0-F2 patients (HLA-B18pos: 69.2%; 18 (6.5-37) months vs HLA-B18neg: 28.2%; 37 (IQR: 19-52) months). These results could impact the timing of HCV therapy in F0-F2 patients.
