Hepatitis C virus activation in HIV-infected patients initiating highly active antiretroviral therapy.
We describe repeated episodes of hepatitis C (HCV) activation associated with initiation of highly active antiretroviral therapy (HAART) in two HIV/HCV coinfected individuals with undetectable serum HCV RNA. Both patients developed high HCV viremia (>1 million IU/mL) and elevations in aminotransferases >10 times upper limit of normal) within 4 months of starting HAART. This is the first report of clinically significant HCV activation in HCV-seropositive patients with initially undetectable HCV viremia. These observations suggest that flares of hepatitis C in the setting of the immune reconstitution inflammatory syndrome can occur even in those patients who have undetectable serum HCV levels prior to HAART initiation.
Kim
H Nina
HN
Department of Medicine, University of Washington, Seattle, Washington 98104, USA. hyangkim@u.washington.edu
Harrington
Robert D
RD
Shuhart
Margaret C
MC
Cook
Linda
L
Morishima
Chihiro
C
Jerome
Keith R
KR
Wang
Chia C
CC
D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D016174:Hepacivirus / Q000187:drug effects* / Q000502:physiology; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000150:complications; D008297:Male; D014763:Viral Matrix Proteins / Q000097:blood; D014766:Viremia; D014775:Virus Activation / Q000187:drug effects*
D019380:Anti-HIV Agents; D014763:Viral Matrix Proteins