title: The risk of infections in HIV-HCV coinfected patients during antiviral therapy with pegIFN+RBV.
abstract: OBJECTIVE
  Antiviral treatment with pegIFN/RBV decreases ANC and CD4+ cell count. An association between neutropenia, a low CD4+ cell count and infections has not been demonstrated so far in HIV-HCV coinfected patients.
  
  
  METHODS
  The incidence, type, and severity of infections were recorded in 85 HIV-HCV coinfected and 164 monoinfected patients receiving pegIFN/RBV for 48 weeks. ANC and CD4+ cell count were assessed every 4 weeks during therapy.
  
  
  RESULTS
  The incidence of infections was significantly higher in HIV-HCV than HCV-Mono (38% vs. 15%; p = 0.001). Types of infections: pneumonia (n = 16/n = 24), bacteraemia/sepsis (n = 5/n = 2), skin infections (n = 15/n = 12), urinary tract infections (n = 4/n = 1), OIs (n = 10/n = 1). The incidence of neutropenia grade 1, 2 3 or 4 was similar in HIV-HCV and HCV-Mono, respectively. The incidence of infections was not associated with neutropenia (HCV-Mono: p = 0.584; HIV-HCV: p = 0.23) or with CD4+ cell counts <200/μL (HIV-HCV: p = 0.29). OIs occurred more often in HIV-HCV patients with CD4+ cell count <200/μL (p = 0.024).
  
  
  CONCLUSIONS
  Up to 38% and 15% of HIV-HCV coinfected and HCV-monoinfected patients develop infections during pegIFN+RBV therapy but without any correlation to neutropenia. Antibacterial prophylaxis/treatment should be considered early in HIV-HCV coinfected patients developing CD4+ cell counts <200/μL during antiviral therapy as these patients have an increased risk of OIs.
authors.affiliation: Medical University of Vienna, Dept. of Internal Medicine III, Div. of Gastroenterology & Hepatology, Austria.
authors.forename: B A
authors.initials: BA
authors.lastname: Payer
authors.forename: T
authors.initials: T
authors.lastname: Reiberger
authors.forename: F
authors.initials: F
authors.lastname: Breitenecker
authors.forename: M C
authors.initials: MC
authors.lastname: Aichelburg
authors.forename: C
authors.initials: C
authors.lastname: Schuster
authors.forename: P M
authors.initials: PM
authors.lastname: Heil
authors.forename: T M
authors.initials: TM
authors.lastname: Scherzer
authors.forename: P
authors.initials: P
authors.lastname: Ferenci
authors.forename: A
authors.initials: A
authors.lastname: Rieger
authors.forename: M
authors.initials: M
authors.lastname: Peck-Radosavljevic
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000008:administration & dosage*; D000998:Antiviral Agents / Q000008:administration & dosage*; D001424:Bacterial Infections / Q000453:epidemiology* / Q000473:pathology; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D015994:Incidence; D007372:Interferons / Q000008:administration & dosage*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000276:immunology; D009894:Opportunistic Infections / Q000453:epidemiology / Q000473:pathology; D012254:Ribavirin / Q000008:administration & dosage*
chemical_list: D044966:Anti-Retroviral Agents; D000998:Antiviral Agents; D012254:Ribavirin; D007372:Interferons