The influence of HCV coinfection on clinical, immunological and virological responses to HAART in HIV-patients.
The potential impact of the hepatitis C virus (HCV) on clinical, immunological and virological responses to initial highly active antiretroviral therapy (HAART) of patients infected with human immunodeficiency virus (HIV) is important to evaluate due to the high prevalence of HIV-HCV coinfection. A historical cohort study was conducted among 824 HIV-infected patients starting HAART at a public referral service in Belo Horizonte, Brazil, to assess the impact of HCV seropositivity on appearance of a new AIDS-defining opportunistic illness, AIDS-related death, suppression of viral load, and an increase in CD4-cell count. A total of 76 patients (9.2%) had a positive HCV test, 26 of whom (34.2%) had a history of intravenous drug use. In multivariate analysis, HCV seropositivity was associated with a smaller CD4-cell recovery (RH=0.68; 95% CI [0.49-0.92], but not with progression to a new AIDS-defining opportunistic illness or to AIDS-related death (RH=1.08; 95% CI [0.66-1.77]), nor to suppression of HIV-1 viral load (RH=0.81; 95% CI [0.56-1.17]) after starting HAART. These results indicate that although associated with a blunted CD4-cell recovery, HCV coinfection did not affect the morbidity or mortality related to AIDS or the virological response to initial HAART.
Carmo
Ricardo A
RA
Hemominas Foundation, Belo Horizonte, Brazil. ricarmo@uai.com.br
Guimarães
Mark D C
MD
Moura
Alexandre S
AS
Neiva
Augusto M
AM
Versiani
Juliana B
JB
Lima
Letícia V
LV
Freitas
Lílian P
LP
Rocha
Manoel Otávio C
MO
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000276:immunology; D006526:Hepatitis C / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D008297:Male; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies; D019562:Viral Load
D018937:Hepatitis C Antibodies; D012367:RNA, Viral