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Prévalence des anticorps antivirus de l’hépatite C chez des patients porteurs de sida sous traitement à Cotonou

Prevalence of hepatitis C virus antibody in patients with acquired immunodeficiency syndrome undergoing antiretroviral treatment in Cotonou

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Journal Africain d'Hépato-Gastroentérologie

Résumé

Résumé

Les buts du présent travail étaient de déterminer la fréquence des anticorps antivirus de l’hépatite C (VHC) chez des patients infectés par le virus de l’immunodéficience humaine (VIH) sous traitement à Cotonou, de décrire le profil clinique des patients porteurs d’anticorps anti-VHC, d’évaluer la pertinence du choix des antirétroviraux (ARV) chez ces patients.

Patients et méthodes

Cent un patients infectés par le VIH sous traitement ont été inclus de façon prospective à l’hôpital d’instruction des armées de Cotonou entre le 15 janvier et le 31 mars 2005. Tous ont bénéficié d’un examen clinique complet, d’un dosage des transaminases et d’un dosage des CD4. La recherche des anticorps anti-VHC a été faite par un test Elisa de troisième génération.

Résultats

Trois patients (3 %) étaient porteurs des anticorps anti-VHC. Il s’agissait de trois patients de sexe féminin, célibataires et d’âge moyen de 33 ans. Les principaux facteurs de risque étaient la transfusion sanguine (2/3), les sacrifications (3/3) et le multipartenariat sexuel actif (3/3). L’hépatomégalie était notée chez deux tiers de nos patients et les signes cliniques de cirrhose dans un cas. La cytolyse était constante et importante (ALAT à 6 N) et l’immunodépression profonde (CD4 à 16/mm3). La durée moyenne du traitement ARV était de 10,6 mois. Le traitement, a posteriori, semblait indapté dans un cas.

Conclusion

Le risque de décès pour cirrhose est élevé chez ces patients traités par ARV en méconnaissance du statut sérologique VHC. Cependant, la non-disponibilité et le coût élevé du traitement antiviral justifient cette attitude thérapeutique.

Abstract

Abstract

The aims of this study were to determine the seroprevalence of hepatitis C virus antibody among patients treated for AIDS in Benin, describe the clinical profile of patients with anti-HCV antibody, and evaluate the pertinence of the choice of antiretroviral drug administered to these patients.

Patients and methods

One hundred and one patients treated with Highly Active Antiretroviral Therapy (HAART) were recorded in The Military Teaching Hospital of Cotonou between January 15th and March 31st, 2005.

Result

Three patients (3%) tested positive for anti-HCV antibody. They were female unmarried, with a mean age of 33. The main risk factors found were blood transfusion (3/3), traditional scarification (3/3), multiple sexual partners (3/3). Hepatomegaly was found in two cases and clinical diagnosis of cirrhosis was made in one of them. Cytolysis was constant and high (ALAT over 6 N) and immune depression was severe (CD4 = 16/mm3). The mean duration of treatment was 10.6 months. The treatment was found to have been unsuitable in one case.

Conclusion

The risk of death is high among patients whose HVC infection is not known, when treated by HAART. However, the non availability and the high cost of antiviral drugs explain this choice of therapy.

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Authors and Affiliations

  1. Service d’hépatogastroentérologie, centre national hospitalier et universitaire de Cotonou, Cotonou, Bénin

    J. Sehonou, N. Kodjoh, I. S. Sama & F. Atadokpédé

  2. Hôpital d’instruction des armées de Cotonou, Cotonou, Bénin

    J. Sehonou & F. Atadokpédé

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  1. J. Sehonou
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  2. N. Kodjoh
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  3. I. S. Sama
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  4. F. Atadokpédé
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Correspondence to J. Sehonou.

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Sehonou, J., Kodjoh, N., Sama, I.S. et al. Prévalence des anticorps antivirus de l’hépatite C chez des patients porteurs de sida sous traitement à Cotonou. J Afr Hepato Gastroenterol 2, 163–166 (2008). https://doi.org/10.1007/s12157-008-0059-4

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  • DOI: https://doi.org/10.1007/s12157-008-0059-4

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