WOMEN COINFECTED WITH HIV AND VHC. PART 1. PSYCHOSOCIAL CHARACTERISTIC AND READINESS TO ANTIVIRAL THERAPY

Abstract

The objective of the present study was the analysis of medical and social status of women co-infected with HIV and VHC with the following assessment of their readiness to antiviral therapy of chronic hepatitis C virus infection (CHC) taking into account the mental health and living conditions and sustaining the adherence to antiviral therapy thereafter. Materials and methods. To clarify the social and psychological status, 100 outpatient cards of women co-infected with HIV/HCV were analyzed. The in-depth study with the assessment of the psychosocial and detoxification status and the adherence to antiretroviral therapy (ART) was held in fifty patients. Results. Most of the women had a long-standing history of HIV infection and HCV. Of these, 78% underwent ART and 84,6% had a high adherence to treatment. The main social problems of the women were connected with their work (34,2%) and family circumstances (26,3%). An increase in the concentration of carbohydrate-deficient transferrin (CDT), the marker of chronic alcohol abuse, was detected in three of 50 patients, and other three of the 50 had this parameter in the zone of unstable values. 72% of the patients showed mental disorders, while more than half of them (60%) had actively used psychoactive substances, and organic symptomatic mental disorder effects were observed in 20% of the patients. Most of the women were in remission on the use of psychoactive substances. Evaluation of the depression and anxiety levels has showed scattered results but in the meantime 54% of the women expressed complaints of asthenic nature, anxious mood was marked in 38% of the patients, 40% of them earlier had been suicidally inclined. Conclusion. Taking into account the social problems in one-third of patients that may negatively affect the treatment of HCV and HIV infection, it is essential to lend complimentary psychological support and assist with solving difficulties before the treatment assignment in order to increase the adherence to treatment. Due to mental health reasons, the patients need continuous observation and periodic condition correction. The majority of surveyed agree ART of CHC at this moment and in the short term but carefully relate to offered treatment regimens and its duration. Given the mental state of the patients, it can be assumed that virus C in women with HIV/HCV co-infection should be treated with direct-acting antiviral agents that do not exacerbate existing disorders. The next issue of the journal .HIV infection and immunosuppression disorders. (2018. Vol. 10, No. 4) will present the results of the study of clinical status features and the prospects for the therapy.