Relation between HIV-1 and hepatitis C viral load in patients with hemophilia.
Coinfection with hepatitis C virus (HCV) and HIV-1 is common in patients with hemophilia and in intravenous drug users. Little, however, is known about the relation between HIV-1 and HCV coinfection and the effects on HCV clearance and pathogenesis. We examined data from 207 HIV-1-infected and 126 HIV-1-uninfected patients with hemophilia enrolled in the multicenter Hemophilia Growth and Development Study. Participants were observed during prospective follow-up for approximately 7 years with annual measurements of alanine aminotransferase (ALT), CD4+ cells, and HCV and HIV-1 RNA levels. Clearance of HCV was more likely to occur in those uninfected with HIV-1 (14.3 versus 2.5%; odds ratio [OR] 4.79; 95% confidence interval [CI], 1.63-14.08, p =.005) and was more common with decreasing age (OR, 1.23; 95% CI, 1.04-1.47; p =.017). HCV RNA levels were higher throughout the 7 years of follow-up in those HIV-1-infected (p <.001). In the HIV-1-infected participants, baseline CD4+ cells were inversely related to HCV RNA with every 100-cell increase associated with a 0.19 log10 copy/ml decrease in HCV RNA (p =.002), and HIV-1 and HCV RNA levels were directly related (p =.008). Increasing HCV RNA levels were also associated with significantly higher ALT levels regardless of HIV-1 infection status. These results demonstrate that HIV-1/HCV co-infection is associated with a reduced likelihood of HCV clearance and that higher levels of HCV RNA are associated with increased hepatic inflammation.
Daar
E S
ES
Cedars-Sinai Burns & Allen Research Institute, Division of Infectious Diseases, Department of Medicine, Los Angeles, CA 90048, USA. Daar@CSHS.org
Lynn
H
H
Donfield
S
S
Gomperts
E
E
Hilgartner
M W
MW
Hoots
W K
WK
Chernoff
D
D
Arkin
S
S
Wong
W Y
WY
Winkler
C A
CA
D000293:Adolescent; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D019380:Anti-HIV Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D002648:Child; D015331:Cohort Studies; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000821:virology*; D015497:HIV-1 / Q000502:physiology*; D006467:Hemophilia A / Q000150:complications* / Q000821:virology*; D016174:Hepacivirus / Q000502:physiology*; D006526:Hepatitis C / Q000150:complications / Q000821:virology*; D006801:Humans; D012367:RNA, Viral / Q000097:blood; D019562:Viral Load
D019380:Anti-HIV Agents; D012367:RNA, Viral; D000410:Alanine Transaminase