HIV-HCV RNA loads and liver failure in coinfected patients with coagulopathy.
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.
Dragoni
F
F
Dipartimento di Biotecnologie Cellulari ed Ematologia, Univ. "La Sapienza", Rome, Italy.
Cafolla
A
A
Gentile
G
G
Mazzucconi
M G
MG
Vella
S
S
Di Corpo
U
U
Tosti
M E
ME
Pisani
G
G
Donato
V
V
Martino
P
P
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
D012367:RNA, Viral; D000410:Alanine Transaminase