M. Micoud

Change in transaminases in hepatitis C virus- and HIV-coinfected patients after highly active antiretroviral therapy : Differences between complete and partial virologic responders?

Patients with HIV and hepatitis C virus (HCV) coinfection have more severe hepatitis-related disease than do patients with HCV infection alone. Highly active antiretroviral therapy (HAART) with protease inhibitor appears to restore pathogen-specific immune responses, especially in patients with persistent undetectable HIV viral load. To evaluate the potent impact of immune restoration induced by HAART on the course of HCV-related disease, HCV viremia and levels of transaminases were compared between two groups of patients: 10 HIV/HCV-coinfected patients with persistently undetectable HIV viremia (group A) and 12 HIV/HCV-coinfected patients with persistent detectable HIV viremia. No difference was detected in HCV viral load in either group. An increase in transaminases was found only in patients with persistent undetectable HIV viral load, which was correlated with the increase in CD8+ T cells. This may suggest that the restoration of CD8+ T cell cytotoxicity could lead to an enhancement of hepatitis C-related disease in HCV/HIV-coinfected patients receiving HAART.

Les bacilles Gram négatif des groupes M5 et EF4 et pathologie des morsures de chiens. Ces bactéries sont-elles pathogènes ?

Resume Des bacilles gram negatif du groupe M5 ont ete retrouves chez 6 patients mordus par un chien. Dans un autre cas, nous avons retrouve un bacille du groupe EF4. Dans ces 7 cas, la symptomatolobie clinique etait identique a celle decrite pour les pasteurelloses. Ces bacteries devraient etre recherchees systematiquement dans toute morsure.