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    Kravchenko L. A.

    STUDY FEATURES OF THE IMMUNE STATUS OF PATIENTS WITH COMBINED COURSE OF CHRONIC HEPATITIS C AND HUMAN IMMUNODEFICIENCY VIRUS


    About the author: Kravchenko L. A.
    Heading CLINICAL MEDICINE
    Type of article Scentific article
    Annotation Introduction. Viral hepatitis with parenteral route of transmission and HIV infection are among the most pressing problems of modern medicine. Objective: To study the main epidemiological, clinical and laboratory features of the manifestations and course of hepatitis C and HIV infection as a mixed pathology, development and substantiation of algorithm of epidemiological diagnosis, treatment and prevention. Materials and methods. To perform this work we conducted clinical and laboratory examination of patients with HIV infection and chronic hepatitis C observed in Center for Prevention and Control of AIDS in Odessa during 2015-2016 years. All patients underwent clinical examination (complaints, medical history of the disease, history life and epidemiological history, physical examination), and basic laboratory and instrumental studies, according to the standards of examination of patients with HIV infection. There were three main clinical groups: 1) patients with chronic hepatitis C (HVHS) – 41 persons; 2) patients with HIV infection (HIV) – 58 persons; 3) patients with mixed infection (HIV + HVHS) – 81 persons. All patients with HIV infection treated with drugs aluvia and Kaletra (lopinavir 200 mg and ritonavir 50 mg), 2 tablets 2 times daily (800/200 mg) orally. Results and discussion. Conducted antiretroviral therapy in patients with HIV has led to improved immunological status of patients. Thus, in patients with HIV reduced the total number of white blood cells, particularly lymphocytes to 30,28%. There were observed reduction of titles markers of cellular immunity: CD3+, CD3+8+ and CD3+19+ cells with simultaneous elevation values of CD3+4+ and CD16+56+ cells, reflecting a general decrease in the intensity of inflammation and restore the number of pool of cells that are target for virus infection. Also there were observed reducing markers of humoral Ig A, Ig M and Ig G at HIV after antiretroviral therapy. Such dynamics observed in the group of patients with combined disease of HIV + HVHS: the total number of lymphocytes decreased to 34,83%, CD3+4+ and CD16+56+ cells demonstrated elevation levels to 612,43±64,22 and 205,32±37,25 cells respectively, and CD3+, CD3+8+ and CD3+19+ cells decreased to 1585,23± 104,87, 1118,36±39,15 and 174,26±23,17 respectively. Humoral immunity markers simultaneously declined as a result of decreasing the viral load of the patient organism and reducing the intensity of inflamatory process. Conclusions. HCV increases viral load of HIV, negatively correlated with the amount of CD4+ T-lymphocytes, and thus – with a degree of immunodeficiency, as confirmed in our study. Antiretroviral therapy demonstrated reduction of cellular immunity markers – lymphocytes, CD3+, CD3+8+, and CD3+19+ cells and decreasing of humoral immunity markers – Ig A, Ig M and Ig G, and elevation of CD3+4+ and CD16+56+ cells and in the group with monopatology HIV and so in the group with comorbid HIV+HCV. The results indicated decreasing of inflamator process and the level of immunodeficiency after antiretroviral therapy in HIV and HIV+HCV groups.
    Tags chronic viral hepatitis C, human immunodeficiency virus, immune status
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    Publication of the article «World of Medicine and Biology» №2(60), 2017 year, 070-075 pages, index UDK 616.981.21/.958.7: 616-036.4