CLINICAL AND PERSONAL STATUS IN WOMEN WITH HIV/HCV CO-INFECTION, ALCOHOL AND DRUG USE AT STAGES OF THE DISEASE
https://doi.org/10.22328/2077-9828-2019-11-4-40-50
Abstract
The objective of the survey: to analyze clinical, psychosocial and personal status in women co-infected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV), and their alcohol addiction. Materials and methods: the check-up of 191 surveyed women with HIV and HCV co-infection taking into account epidemiologic evidence, laboratory parameters: immunologic (CD4 lymphocyte count), virological (HIV and HCV RNA, HCV genotype) and complete and biochemical blood count was made. Detailed check-up of psychosocial and narcological status with the following assessment of alcohol use in 166 surveyed women was made; clinical, laboratory (ethyl glucuronide (EtG) determination in urine and carbohydrate-deficient transferrin (CDT) determination in serum), and instrumental methods. Results: Mean age of patients was 34,9±3,9 years. Most women (88%) had satisfactory social status. Most women had a long-standing co-infection. 3,7% of women were in the subclinical stage of HIV infection, 92.1% had stage 4A, 4B — 11% and 4B — 11%. The median number of CD4 lymphocytes was 470 cells/μl. 92,2% received ART, and 96,7% of women showed a high rate of treatment compliance. Among the prevalent HIV-associated diseases were candidiasis (53,2%) and viral infections (8,1%) and bacterial diseases (3%); a high percentage (15%) of past tuberculosis of various localization was noted. In 89,9% of women, a high replicative activity of HCV was detected in the blood. According to the results of indirect liver elastometry, 98,3% had minimal and moderate fibrosis (METAVIR ≤F2). 86,9% of patients showed total bilirubin level within the normal range, median alanine aminotransferase (ALT) was 62 cells/μl and median aspartate aminotransferase (AST) was 48 cells/μl. Comorbid infectious and non-infectious diseases were diagnosed in 65,4% of women. Antiviral therapy (ART) of chronic hepatitis C was performed in 4,7% of surveyed women who received the combination of pegylated interferon (pegIFN) and ribavirin. Mean history of psychoactive drug use was 7,2±4,1 years. By the time of survey, 96,4% of women denied use of any psychoactive drugs other than alcohol. In past medical history, 81,9% of patients used opioids, regular use of alcohol with the following addiction syndrome was diagnosed in 88,6% of patients. Increasing CDT concentration was revealed in 3 patients and in 3 cases, this parameter was within borderline unstable zone. Under assessment of psychopathologic status, prevalent psychopathologic syndromes were insomnia, psychoorganic syndromes and anxiety. According to aggression scale, high indices by «relational aggression», «irritation», «grievance», «suspicion», «guilt». Prevalent types of attitude to HIV-infecton were ergopathic, sensitive, anosognosic.
About the Authors
N. B. Khalezova
The First Pavlov State Medical University of Saint Petersburg
Russian Federation
St. Petersburg, Russia
Russian Federation
St. Petersburg, Russia
E. V. Boeva
The First Pavlov State Medical University of Saint Petersburg,
St. Petersburg Pasteur Institute of Epidemiology and Microbiology
Russian Federation
St. Petersburg, Russia
Russian Federation
St. Petersburg, Russia
V. V. Rassokhin
The First Pavlov State Medical University of Saint Petersburg,
St. Petersburg Pasteur Institute of Epidemiology and Microbiology,
Institute of Experimental Medicine of Russian Academy of Sciences
Russian Federation
St. Petersburg, Russia
Russian Federation
St. Petersburg, Russia
L. V. Gutova
The First Pavlov State Medical University of Saint Petersburg
Russian Federation
St. Petersburg, Russia
Russian Federation
St. Petersburg, Russia
R. DiClemente
College of Global Public Health of New York University
United States
New York, USA
United States
New York, USA
N. A. Belyakov
The First Pavlov State Medical University of Saint Petersburg,
St. Petersburg Pasteur Institute of Epidemiology and Microbiology
Russian Federation
St. Petersburg, Russia
Russian Federation
St. Petersburg, Russia
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Review
For citations:
Khalezova N.B., Boeva E.V., Rassokhin V.V., Gutova L.V., DiClemente R., Belyakov N.A. CLINICAL AND PERSONAL STATUS IN WOMEN WITH HIV/HCV CO-INFECTION, ALCOHOL AND DRUG USE AT STAGES OF THE DISEASE. HIV Infection and Immunosuppressive Disorders. 2019;11(4):40-50. (In Russ.) https://doi.org/10.22328/2077-9828-2019-11-4-40-50
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