title: Stability of hepatitis C virus (HCV) RNA levels among interferon-naïve HIV/HCV-coinfected individuals treated with combination antiretroviral therapy.
abstract: OBJECTIVE
  Infection with hepatitis C virus (HCV) is a major cause of chronic liver disease. High HCV RNA levels have been associated with poor treatment response. This study aimed to examine the natural history of HCV RNA in chronically HCV/HIV-coinfected individuals.
  
  
  METHODS
  Mixed models were used to analyse the natural history of HCV RNA changes over time in HIV-positive patients with chronic HCV infection.
  
  
  RESULTS
  A total of 1541 individuals, predominantly White (91%), male (73%), from southern (35%) and western central Europe (23%) and with HCV genotype 1 (58%), were included in the analysis. The median follow-up time was 5.0 years [interquartile range (IQR) 2.8 to 8.3 years]. Among patients not on combination antiretroviral therapy (cART), HCV RNA levels increased by a mean 27.6% per year [95% confidence interval (CI) 6.1-53.5%; P = 0.0098]. Among patients receiving cART, HCV RNA levels were stable, increasing by a mean 2.6% per year (95% CI -1.1 to 6.5%; P = 0.17). Baseline HCV RNA levels were 25.5% higher (95% CI 8.8 to 39.1%; P = 0.0044) in individuals with HCV genotype 1 compared with HCV genotypes 2, 3 and 4. A 1 log HIV-1 RNA copies/mL increase in HIV RNA was associated with a 10.9% increase (95% CI 2.3 to 20.2%; P = 0.012) in HCV RNA.
  
  
  CONCLUSIONS
  While HCV RNA levels increased significantly in patients prior to receiving cART, among those treated with cART HCV RNA levels remained stable over time.
authors.affiliation: HIV Epidemiology & Biostatistics Group, Research Department of Infection and Population Health, University College London-Royal Free Campus, London, UK. d.grint@ucl.ac.uk
authors.forename: D
authors.initials: D
authors.lastname: Grint
authors.forename: L
authors.initials: L
authors.lastname: Peters
authors.forename: J
authors.initials: J
authors.lastname: Reekie
authors.forename: V
authors.initials: V
authors.lastname: Soriano
authors.forename: O
authors.initials: O
authors.lastname: Kirk
authors.forename: B
authors.initials: B
authors.lastname: Knysz
authors.forename: O
authors.initials: O
authors.lastname: Suetnov
authors.forename: A
authors.initials: A
authors.lastname: Lazzarin
authors.forename: B
authors.initials: B
authors.lastname: Ledergerber
authors.forename: J K
authors.initials: JK
authors.lastname: Rockstroh
authors.forename: A
authors.initials: A
authors.lastname: Mocroft
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D015331:Cohort Studies; D005060:Europe; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D016174:Hepacivirus / Q000302:isolation & purification*; D019698:Hepatitis C, Chronic / Q000821:virology*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D019562:Viral Load
chemical_list: D044966:Anti-Retroviral Agents; D012367:RNA, Viral