SIGNIFICANCE OF IMMUNOSUPPRESSION AND ELASTOMETRY INDICES OF LIVER IN THE TACTICS OF HIV/HCV CO-INFECTION TREATMENT

Abstract

Objective: Correction of the main treatment regimen for HIV/HCV co-infection, taking into account the degree of immunosuppression based on indices of CD4+ cells in 1 μl of blood and the severity of hepatic fibrosis tissue according to the elastometry of the liver Methods: A complex examination of 21 patients with HIV/HCV co-infection was carried out, according to anamnestic data who are the users of long-term injecting drugs. The diagnosis of HIV infection was confirmed by the positive result of the rapid test, ELISA, (enzyme-linked immunosorbent assay), immunoblotting. Hepatitis C virus is diagnosed by detection by ELISA of serum anti-HCV. To determine the degree of liver fibrosis, the method of elastometry on the FibroScan apparatus (France) was used on the basis of the Institute of Gastroenterology. The results were evaluated on a scale of the degree of fibrosis of liver METAVIR from F0 (healthy liver) to F4 (hepatic cirrhosis). The number of CD4+ lymphocytes in 1 μl of blood was determined by flow cytometry. Results: With a targeted comprehensive examination of 21 patients with HIV/HCV co-infection, pronounced oscillations in the results of elastometry of the hepatic tissue (from F0 to F4), regardless of the number of CD4+ cells (24 to 809 cells/μl) were found. Conclusion: The results obtained indicate that there is no direct correlation between the degree of immunosuppression in CD4+ indices and the process of formation of hepatic fibrosis in patients with co-infection with HIV/HCV, which is a significant additional diagnostic criterion in choosing the priority of therapy.

Keywords

• elastometry
• immunosuppression
• co-infection
• hiv
• hcv.