SIGNIFICANCE OF IMMUNOSUPPRESSION AND ELASTOMETRY INDICES OF LIVER IN THE TACTICS OF HIV/HCV CO-INFECTION TREATMENT
1Department of Infectious Diseases, Avicenna Tajik State Medical University, Dushanbe, Tajikistan
2The Local Center for AIDS Control and Prevention, Dushanbe, Tajikistan
3Institute of Gastroenterology, Dushanbe, Tajikistan
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.
Conclusions: 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.
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Rakhmanov Erkin Rakhimovich, Doctor of Medical Sciences, Full Professor, Head of the Department of Infectious Diseases of Avicenna TSMU
Gulyamova Nazira Minhodzhevna, Candidate of Medical Sciences, Assistant of the Department of Infectious Diseases of Avicenna TSMU
Tsoy Viktoria Nikolaevna, Assistant of the Department of Infectious Diseases of Avicenna TSMU
Sharipov Turakhon Mahmudovich, Candidate of Medical Sciences, Director of the Local Center for HIV/AIDS Prevention and Control
Sayfuddinov Obiddin, Physician of the Liver Elastometry Cabinet, Institute of Gastroenterology
Address for correspondence:
Rakhmanov Erkin Rakhimovich
Doctor of Medical Sciences, Full Professor, Head of the Department of Infectious Diseases of Avicenna TSMU
734003, Republic of Tajikistan, Dushanbe, Rudaki Ave., 139
Tel.: (+992) 951 916000