Hepatitis C virus and human T-lymphotropic virus coinfection: epidemiological, clinical, laboratory and histopathological features

Abstract

Twenty-four hepatitis C virus patients coinfected with human T-lymphotropic virus type 1 were compared with six coinfected with HTLV-2 and 55 with HCV alone, regarding clinical, epidemiological, laboratory and histopathological data. Fischer's discriminant analysis was applied to define functions capable of differentiating between the study groups (HCV, HCV/HTLV-1 and HCV/HTLV-2). The discriminant accuracy was evaluated by cross-validation. Alcohol consumption, use of intravenous drugs or inhaled cocaine and sexual partnership with intravenous drug users were more frequent in the HCV/HTLV-2 group, whereas patients in the HCV group more often reported abdominal pain or a sexual partner with hepatitis. Coinfected patients presented higher platelet counts, but aminotransferase and gamma-glutamyl transpeptidase levels were higher among HCV-infected subjects. No significant difference between the groups was seen regarding liver histopathological findings. Through discriminant analysis, classification functions were defined, including sex, age group, intravenous drug use and sexual partner with hepatitis. Cross-validation revealed high discriminant accuracy for the HCV group. Key-words:Hepatitis C virus. Human T-lymphotropic virus type 1. Human T-lymphotropic virus type 2. Epidemiological studies. Discriminant analysis. RESUMOCompararam-se 24 pacientes coinfectados pelos vírus da hepatite C/vírus linfotrópico de células T humanas do tipo 1 com 6 coinfectados por VHC/ HTLV-2 e 55 infectados pelo VHC, no tocante a dados clínico-epidemiológicos, laboratoriais e histopatológicos. A análise discriminante de Fischer foi utilizada para definir funções capazes de diferenciar os grupos de estudo (VHC, VHC/HTLV-1 e VHC/HTLV-2). A acurácia discriminatória foi avaliada pelo por validação cruzada. O uso de álcool, drogas endovenosas, cocaína inalatória e a parceria sexual com UDEV foram mais freqüentes no grupo VHC/HTLV-2, enquanto queixa de dor abdominal e parceiro sexual com hepatite predominaram no grupo VHC. Os coinfectados apresentaram número maior de plaquetas, enquanto as aminotransferases e a gamaglutamiltranspeptidase foram mais altas no grupo VHC. Não houve diferença entre os grupos à análise histopatológica do fígado. Por análise discriminante definiram-se funções classificatórias, incluindo as variáveis sexo, faixa etária, uso de drogas endovenosas e parceiro sexual com hepatite, com acurácia discriminante alta para o grupo VHC. Palavras-chaves:Vírus da hepatite C. Vírus linfotrópico de células T humanas do tipo 1. Vírus linfotrópico de células T humanas do tipo 2. Estudos epidemiológicos. Análise discriminante.

Hepatitis C virus and human T-cell lymphotropic virus type 1 co-infection: impact on liver disease, virological markers, and neurological outcomes

“…23 However, other groups have postulated that HTLV-1 infection can attenuate hepatic damage, as shown by lower serum levels of aminotransferases and lower degrees of liver fibrosis. 27,28 Similar results were observed in a study with triple HIV, HCV, and HTLV-1 co-infection, in which HTLV-1-infected patients presented better outcomes for HCVassociated liver fibrosis. 26 The present study was performed to provide new insights into the interactions between HCV and HTLV-1 infections through an evaluation of abnormalities in hepatic parameters and the neurological outcomes of HCV/HTLV-1 co-infection.…”

“…The study groups displayed some similar characteristics to those of previous studies, such as a higher frequency of females among HTLV-1-infected patients, 3 and a predominance of males among HCV/HTLV-1 co-infected individuals. [26][27][28] Considering the infection routes, IDU was more frequent in the HCV/HTLV-1 co-infected group, as described previously. 36,37 It has been shown that IDU is a risk factor for coinfection involving HIV, HCV, and especially HTLV-2 in southern Brazil.…”

HCV/HTLV coinfection: Does HTLV-1 interfere in the natural history of HCV-related diseases?

“…No particular risk factor could be identified for HTLV/HCV coinfected patients in Brazil. The use of intravenous drugs did not seem to be an important risk factor for these parenterally transmitted viruses; however, the use of unsafe injections for licit medicines in the past was likely responsible for most cases of HCV transmission in many parts of the country during the 1970s and 80s [Paraná et al, ; Cardoso et al, ; Milagres et al, ].…”

Seroepidemiology of human T‐cell lymphotropic virus among Iranian adult thalassemic patients

“…In a study among a group of the US thalassemia patients, 1·3 and 18·8% were anti‐HTLVAb and anti‐HCVAb positive, respectively, and 1 (0·45%) patient was found to be co‐infected with HCV/HTLV (Switzer et al , ). As HCV and HTLV‐1/2 can be transmitted by blood transfusion, the higher occurrence of co‐infection is expected in the populations at higher risk of blood‐borne viral infections (Milagres et al , ). In spite of HTLV‐associated illnesses that may occur in infected patients, the HTLV influences chronic hepatitis C outcome.…”

“…Evidences indicated that HTLV‐1 produces a functional impairment of cellular immune response. A study reported that the host and virus interaction can lead to cellular immune dysfunction in HCV/HTLV‐co‐infected patients, which might impair HCV clearance and lead to hepatitis C aggressive forms consequently (Milagres et al , ). As thalassemic patients need chronic blood transfusion that exposes them to different blood‐borne pathogens, HCV/HTLV co‐infection is prevalent among these patients, and as a result chronic hepatitis C should be treated promptly.…”