title: HIV-HCV RNA loads and liver failure in coinfected patients with coagulopathy.
abstract: OBJECTIVE
  The aim of this study was to measure contemporaneously HCV-RNA load, HIV-RNA load and CD4+ lymphocyte count in HCV/HIV coinfected patients with coagulopathy and to examine the relationship between these parameters and the liver failure.
  
  
  METHODS
  A cross-sectional study was performed on 54 patients with severe coagulopathy: 39 HCV/HIV coinfected and 15 HCV+/HIV- comparable for age and HCV exposure time. HCV-RNA and HIV-RNA load, CD4+ lymphocyte count, biochemical and ultrasonographic parameters were evaluated at the time of entry to the study.
  
  
  RESULTS
  Mean HCV-RNA load was significantly higher in coinfected patients (643,872 717,687 copies/mL) than in HCV+/HIV- (mean 161,573 276,896 copies/mL) (p = 0.01). The 39 HCV/HIV coinfected patients had a mean HIV-RNA load of 205,913 456,311 copies/mL (range 4,000-2,500,000) and a mean CD4+ lymphocyte count of 206.5171/microL (range 5-693). Five of the 39 (12.8%) coinfected patients had liver failure. In these five patients the mean HCV-RNA load (770,200 996,426 copies/mL) was high but not significantly different from that in the 34 HCV+/HIV+ patients (623,496 682,239 copies/mL) without liver failure (p = 1.0). Coinfected patients with liver failure had a significantly higher HIV-RNA load (mean 764, 599 978,542 copies/mL) and lower CD4+ lymphocyte count (mean 52.655. 6/microL) than those observed in coinfected patients without liver failure (p = 0.007 and p = 0.03, respectively). A significant inverse correlation was found between CD4+ lymphocyte count and HIV-RNA load (r = -0.37, p = 0.01).
  
  
  CONCLUSIONS
  HCV-RNA load is significantly higher in HIV+ than in HIV- patients with coagulopathy. Liver failure was found only in the HCV/HIV coinfected patients with severe immunodepression, expressed either by low CD4+ lymphocyte count or by high HIV-RNA load.
authors.affiliation: Dipartimento di Biotecnologie Cellulari ed Ematologia, Univ. "La Sapienza", Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Dragoni
authors.forename: A
authors.initials: A
authors.lastname: Cafolla
authors.forename: G
authors.initials: G
authors.lastname: Gentile
authors.forename: M G
authors.initials: MG
authors.lastname: Mazzucconi
authors.forename: S
authors.initials: S
authors.lastname: Vella
authors.forename: U
authors.initials: U
authors.lastname: Di Corpo
authors.forename: M E
authors.initials: ME
authors.lastname: Tosti
authors.forename: G
authors.initials: G
authors.lastname: Pisani
authors.forename: V
authors.initials: V
authors.lastname: Donato
authors.forename: P
authors.initials: P
authors.lastname: Martino
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001778:Blood Coagulation Disorders / Q000150:complications*; D015496:CD4-Positive T-Lymphocytes / Q000166:cytology; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006678:HIV / Q000235:genetics*; D015658:HIV Infections / Q000097:blood / Q000000981:diagnostic imaging; D016174:Hepacivirus / Q000235:genetics*; D006526:Hepatitis C / Q000097:blood / Q000000981:diagnostic imaging; D006801:Humans; D008099:Liver / Q000033:anatomy & histology; D017093:Liver Failure / Q000209:etiology* / Q000821:virology; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011169:Portal Vein / Q000033:anatomy & histology; D012367:RNA, Viral / Q000097:blood*; D013154:Spleen / Q000033:anatomy & histology; D014463:Ultrasonography
chemical_list: D012367:RNA, Viral; D000410:Alanine Transaminase