HIV/HCV Coinfection Does Not Impair Virological or Immunological Response to Antiretroviral Therapy

		SUMMARY: HIV positive patients coinfected with hepatitis C virus (HCV) achieved HIV viral load suppression and CD4 cell recovery on antiretroviral therapy similar to that of people with HIV alone, according to a study from China described in the June 1, 2010 Journal of Acquired Immune Deficiency Syndromes. Coinfected individuals with detectable HCV antibodies and HCV RNA, however, appeared more likely to experience certain antiretroviral side effects.

By Liz Highleyman

HIV/HCV coinfected people do not respond as well, on average, to interferon-based therapy for chronic hepatitis C, but research on response to HIV treatment has been mixed; some studies have found coinfected patients tend to experience smaller CD4 T-cell gains, but others have seen no difference.

In the present analysis, Guo Fuping from the Chinese Academy of Medical Sciences in Beijing and colleagues assessed the influence of HCV coinfection on treatment of HIV patients receiving highly active antiretroviral therapy (HAART) regimens containing nevirapine (Viramune), a drug that can cause hypersensitivity reactions characterized by skin rash and liver toxicity.

The study enrolled 175 HIV positive antiretroviral-naive Chinese adults who started HAART and attended follow-up visits during 2005-07. Participants were grouped according to HCV status; 117 were HCV antibody negative, 24 were HCV antibody positive but HCV RNA negative, and 34 were positive on both tests. The researchers collected data on clinical, virological, and immunological responses, as well as adverse events.

Results

	Patients who were both HCV antibody positive and HCV RNA positive had a significantly higher incidence of rash and liver toxicity than people who were HCV antibody negative or HCV antibody positive but HCV RNA negative.
	There was no statistically significant difference in HIV viral load suppression among the 3 groups.
	CD4 and CD8 T-cell responses were also similar across all 3 groups.

Based on these findings, the study authors concluded, "HCV/HIV coinfection does not affect immunological and virological responses to HAART."

However, they continued, patients with positive serum HCV antibodies and HCV RNA had worse adverse drug reactions to HAART such as rash and hepatotoxicity.

Investigator affiliation: Department of Infectious Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.

6/15/10

Reference
G Fuping, LV Wei, H Yang, and others. Impact of Hepatitis C Virus Coinfection on HAART in HIV-Infected Individuals: Multicentric Observation Cohort. Journal of Acquired Immune Deficiency Syndromes 54(2): 137-142 (Abstract). June 1, 2010.