Hepatitis C virus viremia in HIV-infected individuals with negative HCV antibody tests.
Hepatitis C virus (HCV) viremia may occur in persons without detectable HCV antibodies and has been reported in as many as 5.5% of HIV-positive persons. To better characterize serosilent HCV infection, the authors prospectively tested 131 HIV-positive persons and 102 HIV-negative control subjects with diabetes for the presence of HCV antibody (Ab) and HCV RNA. Thirty of 31 HCV Ab-positive (AbP) HIV-positive people tested positive for HCV RNA as did both HCV AbP, HIV-negative control subjects. Similarly, none of the 100 HIV-negative, HCV Ab-negative (AbN) control subjects was HCV RNA positive (p<.001). In contrast, 19 of 100 HIV-positive, HCV AbN persons met stringent criteria for HCV viremia, and 9 of these 19 people were HCV RNA positive when tested by a commercially available HCV RNA detection method. The mean duration of HCV viremia in HCV AbN people was 26.8 months (range, 1-99 months). None of the subjects developed HCV antibody during the study. The HIV-positive, HCV AbP, and RNA-positive group was significantly more likely to have acquired HIV parenterally (p<.001), have higher initial CD4 counts (p=.029), and have higher ALT values than the HCV AbN group (p<.002). In summary, HCV infection appears to occur more frequently among HIV-infected, HCV-seronegative persons than appreciated, especially if HIV acquisition was through sexual as opposed to parenteral risk factors and was associated with a lower initial CD4 count and lower ALT values.
George
Sarah L
SL
Department of Internal Medicine, Iowa City Veterans Administration Medical Center, University of Iowa, College of Medicine, 52242, USA.
Gebhardt
Jenny
J
Klinzman
Donna
D
Foster
Mathew B
MB
Patrick
Kevin D
KD
Schmidt
Warren N
WN
Alden
Beth
B
Pfaller
Michael A
MA
Stapleton
Jack T
JT
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000276:immunology / Q000821:virology*; D018023:HIV Seronegativity; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification*; D018937:Hepatitis C Antibodies / Q000097:blood*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000276:immunology / Q000821:virology*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood*; D013997:Time Factors; D014766:Viremia
D018937:Hepatitis C Antibodies; D012367:RNA, Viral; D000410:Alanine Transaminase