Structural and metabolic changes in the central nervous system in women with HIV/HCV co-infection
The purpose statement is to study the medical and social status and radiological changes in the CNS in women of reproductive age with HIV/HCV co-infection.Materials and methods. The main group (n=36) consisted of patients with HIV/HCV and co-infection. The comparison group (n=36) consisted of women infected with HIV only. Within the framework of this study, clinical, laboratory (general clinical, biochemical, immunological, virological), and instrumental methods of research were used. All women with HIV/HCV and coinfection underwent indirect liver elastometry. The list of radiation research methods included PET/CT with FDG and MRI of the brain. Statistical processing and comparison of the results was carried out using MS Excel 2010 and GraphPad Prism 8 (GraphPad Software, Inc., USA) in accordance with the standards of mathematical statistics. The criterion of statistical significance of the findings was the value of p<0.01. Results and discussion. According to the criteria for inclusion in the study, patients in the comparison groups had an acceptable level of social adaptation, satisfactory indicators of the immune status, in 2⁄3 cases they achieved virological suppression against the background of antiretroviral therapy. HCV RNA was detected in 25 women (69.4%), pronounced manifestations of fibrotic changes in the liver were found in 6 (12.8%) patients. Radiation studies of the CNS revealed structural changes in 1⁄3 of cases, disorders of glucose metabolism of various localizations in all women with HIV/CHC. In patients with co-infection, compared with women infected with HIV, hypometabolism of glucose in various parts of the brain is significantly more often detected. Conclusion. As a result of a comprehensive clinical and neuroimaging examination, certain changes in the metabolic function of the brain were identified, which are characteristic of women with HIV/HCV co-infection. The use of PET/CT with FDG in some cases makes it possible to detect preclinical signs of VANR, as well as possible early manifestations of neurological disorders. Key words: human immunodeficiency virus, viral hepatitis C, HCV, chronic hepatitis C, CHC, women of reproductive age, central nervous system, PET, MRI, structural changes, metabolic disorders>˂ 0.01.Results and discussion. According to the criteria for inclusion in the study, patients in the comparison groups had an acceptable level of social adaptation, satisfactory indicators of the immune status, in 2⁄3 cases they achieved virological suppression against the background of antiretroviral therapy. HCV RNA was detected in 25 women (69.4%), pronounced manifestations of fibrotic changes in the liver were found in 6 (12.8%) patients. Radiation studies of the CNS revealed structural changes in 1⁄3 of cases, disorders of glucose metabolism of various localizations in all women with HIV/CHC. In patients with co-infection, compared with women infected with HIV, hypometabolism of glucose in various parts of the brain is significantly more often detected.Conclusion. As a result of a comprehensive clinical and neuroimaging examination, certain changes in the metabolic function of the brain were identified, which are characteristic of women with HIV/HCV co-infection. The use of PET/CT with FDG in some cases makes it possible to detect preclinical signs of VANR, as well as possible early manifestations of neurological disorders.