This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (34)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

A Study of 177 Patients

Bernard Cribier, MD, PhD; David Rey, MD; Georges Uhl, MD; Christophe Le Coz, MD; Christine Hirth, MD; Eric Libbrecht, MD; Denis Vetter, MD; J.-Marie Lang, MD; Françoise Stoll-Keller, MD; Edouard Grosshans, MD

Arch Dermatol. 1996;132(12):1448-1452.

Abstract
Objective
Many cases of porphyria cutanea tarda have been described in association with human immunodeficiency virus (HIV) infection in young individuals. The link between hepatitis C virus (HCV) and porphyria cutanea tarda is even stronger as more than 50% of patients who have this diagnosis in Italy, France, or Spain are also infected by HCV. To study the role of viral infections on the metabolism of porphyrins, we measured the urinary porphyrin levels in patients with HIV and HCV infections.

Design
Survey; prospective study.

Setting
University Hospital of Strasbourg, France.

Patients
Sixty-one HIV-positive patients, 56 HCV-positive patients, 60 HIV- and HCV-positive patients, and 51 HIV- and HCV-negative control subjects were randomly selected. None had clinical signs of porphyria or a familial history of porphyria.

Main Outcome Measures
The porphyrin-excretion profile was determined by high-performance liquid chromatography on fresh urine samples. The HIV and HCV viremias were quantified in the serum by the branched DNA assay. Measures were planned before data collection began.

Results
The porphyrin-excretion profile typical of porphyria cutanea tarda was found in only 1 of 177 patients. In the remaining 176 patients, the mean coproporphyrin level was significantly raised in HCV-positive patients and even higher in patients who were HIV- and HCV-positive. The coproporphyrin level was not correlated to the alanine aminotransferase level, the CD4⁺ cell count, or the HCV and HIV viremias.

Conclusions
In cases of infection with HIV, HCV, or both, the development of a porphyria cutanea tarda urinary profile is a rare event (0.56% in this study), but coproporphyrin excretion is increased. This could be related to hepatic changes induced by the viruses. Our results do not support the hypothesis of a direct viral effect on the porphyrin metabolism. Infection with HIV, HCV, or both may be a major triggering factor, but is not sufficient to induce porphyria.

Arch Dermatol. 1996;132:1448-1452

Author Affiliations
From the Dermatology Clinic (Drs Cribier, Le Coz, and Grosshans), Centre d'Information et de Soins de l'Immunodéficience Humaine (Drs Rey, Libbrecht, and Lang), the Hepatogastroenterology Department (Drs Uhl and Vetter), the Laboratory of Biochemistry (Dr Hirth), and the Institute of Virology (Dr Stoll-Keller), Strasbourg University Hospital, Strasbourg, France.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Type of Impaired Porphyrin Metabolism Caused by Hepatitis C Virus Is Not Porphyria Cutanea Tarda but Chronic Hepatic Porphyria
Gomi et al.
Arch Dermatol 1997;133:1170-1171.
ABSTRACT  

Type of Impaired Porphyrin Metabolism Caused by Hepatitis C Virus Is Not Porphyria Cutanea Tarda but Chronic Hepatic Porphyria-Reply
O'Connor et al.
Arch Dermatol 1997;133:1171-1171.
ABSTRACT  

Porphyria Cutanea Tarda in HIV andHCV Infection
Journal Watch Dermatology 1997;1997:3-3.
FULL TEXT  

Hepatitis C Virus and Human Immunodeficiency Virus Infection Can Alter Porphyrin Metabolism and Lead to Porphyria Cutanea Tarda
Blauvelt
Arch Dermatol 1996;132:1503-1504.
ABSTRACT