Concurrent Infection with Hepatitis C Virus andStreptococcus pneumoniae

Abstract

Little is known about concurrent infection with hepatitis C virus (HCV) and Streptococcus pneumoniae, which causes invasive pneumococcal disease (IPD). We hypothesized that co-infection with HCV and S. pneumoniae would increase risk for death and complications. We captured sociodemographic and serologic data for adults with IPD in a population-based cohort study in northern Alberta, Canada, during 2000–2014. IPD patients infected with HCV were compared with IPD patients not infected with HCV for risk of in-hospital deaths and complications by using multivariable logistic regression. A total of 355 of 3,251 patients with IPD were co-infected with HCV. The in-hospital mortality rate was higher for IPD patients infected with HCV. Prevalence of most IPD-related complications (e.g., cellulitis, acute kidney injury, mechanical ventilation) was also higher in HCV-infected patients. Infection with HCV is common in patients with IPD, and HCV is independently associated with an increased risk for serious illness and death.

Epidemiological Trend of Sepsis in Patients with Hospital Admissions Related to Hepatitis C in Spain (2000–2015): A Nationwide Study

“…As these patients got older, liver disease progressed, and the burden of chronic hepatitis C disease increased [ 38 ]. Additionally, cirrhosis increases the risk of infections due to unspecific immune dysfunctions added to the increased bacterial translocation [ 12 , 13 , 17 ], and the predisposition of patients infected with HCV to develop other infectious diseases [ 9 , 10 , 11 ]. Once the infection is established, the excessive immune response plus the hemodynamic dysfunction related to cirrhosis favors the development of sepsis [ 16 ].…”

“…Several studies have shown an increased risk of bacterial infection and sepsis in HCV-infected patients [ 14 , 15 , 62 ], even if they have not developed cirrhosis [ 10 , 16 ]. In HCV-infected patients, invasive pneumococcal disease [ 9 ] and Staphylococcus aureus infection [ 63 ] are among the most common bacterial infections. In cirrhotic patients, the endogen infections due to enteric Gram (−) bacteria and Enterococcus spp.…”

“…HCV-infected patients are also predisposed to other infectious diseases [ 9 , 10 , 11 ], possibly because it shares transmission routes with these pathogens or due to the dysregulation of the immune system that appears during chronic hepatitis C, particularly in the advanced stage of cirrhosis [ 12 , 13 ]. Alvaro-Meca et al (2016) found that HCV-infected patients with decompensated cirrhosis have a higher incidence of sepsis than patients with compensated cirrhosis admitted to the intensive care unit (ICU) [ 14 ].…”

Avaliação do risco e causas de óbito entre indivíduos diagnosticados com hepatite C através de exames de triagem para doação de sangue, no período de 1994 a 2016, em um hemocentro de São Paulo-SP

“…Dessa forma, esses dados demonstram a importância de se buscar a presença de distúrbios psiquiátricos entre indivíduos infectados pelo vírus da hepatite C, para que assim possam ser trabalhadas medidas de prevenção para eventos que podem, como visto, levarem a um incremento da morbimortalidade.No presente estudo, as infecções estiveram associadas a um risco quase três vezes maior de morte em indivíduos positivos para o HCV. Uma associação entre a infecção pelo HCV e risco aumentado para infecções bacterianas já foi relatada anteriormente[122][123][124][125][126] . Tuberculose, pneumonia adquirida na comunidade ou infecções bacterianas entre pacientes em hemodiálise são muito mais frequentes em indivíduos infectados pelo HCV[122][123][124][125][126] .…”

“…Uma associação entre a infecção pelo HCV e risco aumentado para infecções bacterianas já foi relatada anteriormente[122][123][124][125][126] . Tuberculose, pneumonia adquirida na comunidade ou infecções bacterianas entre pacientes em hemodiálise são muito mais frequentes em indivíduos infectados pelo HCV[122][123][124][125][126] . A coinfecção com o HIV e o uso de drogas injetáveis também são mais comuns em pacientes infectados pelo HCV e podem levar a maiores taxas de mortalidade por sepse15 .…”