Alterações dermatológicas em pacientes coinfectados cronicamente pelos vírus da Hepatite C e HIV em comparação com pacientes infectados apenas pelo vírus da hepatite C ou HIV atendidos no Hospital Universitário Cassiano Antônio Moraes - Vitória (Espírito Santo) – Brasil
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Data
2018-08-07
Autores
Medeiros, Karina Bittencourt
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Universidade Federal do Espírito Santo
Resumo
Background: The skin is affected in more than 90% of human immunodeficiency virus patients throughout the disease. And those infected by hepatitis C virus, 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 human immunodeficiency virus and hepatitis C virus. Objective: To determine the dermatoses in patients coinfected by hepatitis C virus and human immunodeficiency virus and to compare them with the monoinfected by hepatitis C virus or human immunodeficiency virus. Patients and methods: A cross-sectional, descritive study was performed at the Cassiano Antônio Moraes University Hospital in Vitória (ES) in patients coinfected with hepatitis C virus and human immunodeficiency virus and in the groups infected by human immunodeficiency virus or hepatitis C virus. Skin, oral mucosa and nails were examined in the search for dermatoses and the presence of pruritus was recorded. Results: A total of 134 patients were examined, 31 human immunodeficiency virus/hepatitis C virus coinfected, 62 human immunodeficiency virus infected and 41 hepatitis C virus infected. Compared to human immunodeficiency virus monoinfected individuals, the 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 infected by 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 compared to those coinfected. When evaluating pruritus, the coinfected group showed no difference in compared to the human immunodeficiency virus infected group, but was more present in the hepatitis C virus infected individuals than in those coinfected (OR:1.963, p=0.001). Discussion and conclusion: The coinfected patients were more likely to present dermatoses suggestive of liver disease than those infected with hepatitis C virus or human immunodeficiency virus. Such differance occurs due to hepatic disease itself, aggravated by human immunodeficiency virus coinfection. The coinfected patients had a higher frequency of 14 dyschromia than the human immunodeficiency virus monoinfected group. Pruritus was not significantly different in its frequency in the human immunodeficiency virus monoinfected group compared to coinfected but was more present in the hepatitis C virus monoinfected group, possibly due to human immunodeficiency virus interference in the mechanisms of hepatitis C virus pruritus. Human immunodeficiency virus / hepatitis C virus coinfection predisposed to 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 the suspicion towards the double human immunodeficiency virus / hepatitis C virus infection.
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Hepatitis C , Coinfection , Cutaneous manifestations , Pruritus , Hepatite C , HIV , Coinfecção , Manifestações cutâneas , Prurido