title: Spontaneous viral clearance, viral load, and genotype distribution of hepatitis C virus (HCV) in HIV-infected patients with anti-HCV antibodies in Europe.
abstract: BACKGROUND
  Variables influencing serum hepatitis C virus (HCV) RNA levels and genotype distribution in individuals with human immunodeficiency virus (HIV) infection are not well known, nor are factors determining spontaneous clearance after exposure to HCV in this population.
  
  
  METHODS
  All HCV antibody (Ab)-positive patients with HIV infection in the EuroSIDA cohort who had stored samples were tested for serum HCV RNA, and HCV genotyping was done for subjects with viremia. Logistic regression was used to identify variables associated with spontaneous HCV clearance and HCV genotype 1.
  
  
  RESULTS
  Of 1940 HCV Ab-positive patients, 1496 (77%) were serum HCV RNA positive. Injection drug users (IDUs) were less likely to have spontaneously cleared HCV than were homosexual men (20% vs. 39%; adjusted odds ratio [aOR], 0.36 [95% confidence interval {CI}, 0.24-0.53]), whereas patients positive for hepatitis B surface antigen (HBsAg) were more likely to have spontaneously cleared HCV than were those negative for HBsAg (43% vs. 21%; aOR, 2.91 [95% CI, 1.94-4.38]). Of patients with HCV viremia, 786 (53%) carried HCV genotype 1, and 53 (4%), 440 (29%), and 217 (15%) carried HCV genotype 2, 3, and 4, respectively. A greater HCV RNA level was associated with a greater chance of being infected with HCV genotype 1 (aOR, 1.60 per 1 log higher [95% CI, 1.36-1.88]).
  
  
  CONCLUSIONS
  More than three-quarters of the HIV- and HCV Ab-positive patients in EuroSIDA showed active HCV replication. Viremia was more frequent in IDUs and, conversely, was less common in HBsAg-positive patients. Of the patients with HCV viremia analyzed, 53% were found to carry HCV genotype 1, and this genotype was associated with greater serum HCV RNA levels.
authors.affiliation: Service of Infectious Diseases, Hospital Carlos III, Madrid, Spain. vsoriano@dragonet.es
authors.forename: Vincent
authors.initials: V
authors.lastname: Soriano
authors.forename: Amanda
authors.initials: A
authors.lastname: Mocroft
authors.forename: Juergen
authors.initials: J
authors.lastname: Rockstroh
authors.forename: Bruno
authors.initials: B
authors.lastname: Ledergerber
authors.forename: Brygida
authors.initials: B
authors.lastname: Knysz
authors.forename: Saulius
authors.initials: S
authors.lastname: Chaplinskas
authors.forename: Lars
authors.initials: L
authors.lastname: Peters
authors.forename: Anders
authors.initials: A
authors.lastname: Karlsson
authors.forename: Christine
authors.initials: C
authors.lastname: Katlama
authors.forename: Carlos
authors.initials: C
authors.lastname: Toro
authors.forename: Bernd
authors.initials: B
authors.lastname: Kupfer
authors.forename: Martin
authors.initials: M
authors.lastname: Vogel
authors.forename: Jens
authors.initials: J
authors.lastname: Lundgren