DERMATOLOGICAL CHANGES IN PATIENTS CRONELY CONCERNED BY HEPATITIS C AND HIV VIRUSES IN COMPARISON WITH PATIENTS INFECTED ONLY BY THE HEPATITIS C OR HIV VIRUS AT THE CASSIANO ANTÔNIO MORAES UNIVERSITY HOSPITAL - VITÓRIA (ESPÍRITO SANTO) - BRAZIL
Name: Karina Bittencourt Medeiros
Type: MSc dissertation
Publication date: 07/08/2018
Advisor:
Name |
Role |
|---|---|
| Lucia Martins Diniz | Advisor * |
Examining board:
| Name |
Role |
|---|---|
| Crispim Cerutti Junior | External Examiner * |
| Lucia Martins Diniz | Advisor * |
| Luciana Lofego Gonçalves | Internal Examiner * |
| Maria da Penha Zago Gomes | Internal Examiner * |
Summary: Background: The skin is affected in more than 90% of HIV/AIDS patients throughout the disease. And those infected by HCV, between 40 and 74% present at least one extrahepatic manifestation in the course of the disease. In studies of cutaneous conditions, there are few data in the literature about incidence, prevalence and clinical specificities in those coinfected with HIV and HCV.
Objective: To determine the dermatoses in patients coinfected by HCV and HIV and to compare them with the monoinfected by HCV or HIV.
Patients and methods: A cross-sectional, analytical and comparative study was performed at the Cassiano Antônio Moraes Hospital (HUCAM) in Vitória (ES) in patients coinfected with HCV and HIV and in the control group, those infected by HIV or HCV. Skin, oral mucosa and nails were examined in the search for dermatoses and noted the presence of pruritus.
Results: A total of 134 patients were examined, 31 HIV/HCV coinfected, 62 HIV infected and 41 HCV. Compared with HIV monoinfected individuals, the HIV/HCV coinfected group had more cases of dermatoses suggestive of hepatic alterations (OR:3,040, p=0.001) and more cases of dyschromias (OR:2,315, p=0.005). The group coinfected with HCV infected had more skin infections (OR:2.272, p=0.002) and more cases of dermatoses suggestive of hepatic alterations (OR:2,536, p=0.002). When evaluating pruritus, the coinfected group showed no difference in relation to the HIV infected, but was more present in the HCV-infected than in the coinfected ones (OR:1,963, p=0.001). The coinfected group in relation to HCV monoinfected group had more skin infections (OR:2,272, p=0,002) and more cases of dermatoses suggestive of hepatic alterations (OR:2,536, p=0.002). When evaluating pruritus, the coinfected group showed no difference in relation to the HIV infected, but was more present in the HCV infected than in the coinfected ones (OR:1,963, p=0.001).
Discussion and conclusion: The HIV/HCV patients were more likely to present dermatoses suggestive of liver disease than those infected with HCV or HIV. Such alteration occurs due to hepatic disease itself, aggravated by HIV coinfection. The HIV/HCV patients had a higher frequency of dyschromia than the HIV positive group. Pruritus was not significant in the HIV monoinfected group compared to coinfected but was more present in the HCV monoinfected group, possibly due to HIV interference in the mechanisms of HCV pruritus. HIV/HCV co-infection predisposed the increased frequency of infectious dermatoses, dyschromia and cutaneous alterations of liver diseases and contributed to the reduction of cutaneous pruritus. Patients with cutaneous stigmata of hepatic abnormalities, but without pruritus can direct to double HIV / HCV infection.
Key-words: Hepatitis C, HIV, Coinfection, Cutaneous manifestations, pruritus.
