Liver damage and kinetics of hepatitis C virus and human immunodeficiency virus replication during the early phases of combination antiretroviral treatment.
In order to assess the relationship between human immunodeficiency virus (HIV) RNA, hepatitis C virus (HCV) RNA, CD4, CD8, and liver enzymes during combination antiretroviral therapy, these parameters were measured in 12 HIV-HCV-coinfected patients (who were naive for antiretrovirals) on the day before and 3, 7, 14, 28, 56, and 84 days after initiating the following treatments: stavudine and lamivudine in all patients, indinavir in 6 patients, and nevirapine in 6 patients. HIV RNA declined rapidly, CD4 cells increased slowly, and CD8 cells and liver enzymes were stable. HCV RNA showed a transient significant increase at days 14 and 21 (7.33+/-0.16 [mean +/- SE] and 7.29+/-0.2 log copies/mL vs. 7+/-0.2 log copies/mL at baseline; P<.05). These changes were similar in both treatment groups. A 2-fold alanine aminotransferase increase was observed in 4 of 12 patients; 4 of 4 patients showed increased HCV RNA. The relationship between HCV RNA increase and HIV RNA decrease indicates virus-virus interference. An HCV RNA increase may cause significant liver damage only in a minority of patients.
Puoti
M
M
Clinica di Malattie Infettive e Tropicali, Spedali Civili, P.le Ospedale Civili 1, I 25123 Brescia, Italy. puoti_brambilla@iol.it
Gargiulo
F
F
Quiros Roldan
E
E
Chiodera
A
A
Palvarini
L
L
Spinetti
A
A
Zaltron
S
S
Putzolu
V
V
Zanini
B
B
Favilli
F
F
Turano
A
A
Carosi
G
G
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D006678:HIV / Q000302:isolation & purification*; D015658:HIV Infections / Q000188:drug therapy / Q000821:virology*; D016174:Hepacivirus / Q000302:isolation & purification*; D006526:Hepatitis C / Q000821:virology*; D006801:Humans; D008099:Liver / Q000503:physiopathology*; D008297:Male; D010865:Pilot Projects; D012367:RNA, Viral / Q000032:analysis; D014779:Virus Replication
D019380:Anti-HIV Agents; D012367:RNA, Viral; D000410:Alanine Transaminase