Follow up of HCV reinfection, liver fibrosis progression and nutritional assessment in treated HCV/HIV Co-infected patients / Mohamed Abdallah Abdelaziz Abdallah ; Supervised Hasan Ahmed Ali Elgarem , Neveen Helmy AboulSoud , Mohamed Ahmed Mohey Eldin

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Tropical Medicine

Background: Due to similarities in their mode of transmission; a large group of HIV/HCV has been discovered. An estimated 4{u2013}5 million people are infected with both HIV and HCV worldwide. Combined infection accelerates disease progression in addition to large numbers of HCV relapse after treatment. Treatment decision is always complicated due to poor immune state and drug-drug interactions with anti-retroviral therapy. Aim: We aim to assess the sustained virologic response, Re-infection, Liver fibrosis progression in combined HCV/HIV patients who are treated for HCV with special emphasis on their nutritional needs. Patient and methods: Fifty eligible patients with confirmed genotype 4 HCV/HIV co-infection were enrolled. They received HCV treatment (12 weeks of 400 mg of sofosbuvir daily plus daclatasvir 60 mg daily with dose adjustment for concomitant antiretroviral medications). Assessment of virologic response, re-infection, Liver fibrosis, biochemical changes were done up to 24 weeks after treatment. Results: Mean age of study participants was 34.68±10.38 years, 70% were on anti-retroviral therapy. Sustained virologic response at SVR24 was 93.48%. Hepatitis C eradication cause a significant improvement in liver transaminases (P Value: <0.001) and platelet count (P Value: 0.001). Significant liver fibrosis regression was noticed at SVR24 (P Value: 0.0008). Mean CD4 level were significantly improved (P Value: 0.0652). Conclusion: Treatment of HCV using Sofosbuvir / Daclatasvir regimen is highly effective, with a good safety profile. HCV eradication aids in liver fibrosis regression and normalization of liver transaminases

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