title: Predictors of Chronic Hepatitis C Evolution in HIV Co-Infected Patients From Romania.
abstract: BACKGROUND
  Due to a recent alarming increase in the number of HIV-HCV co-infected patients in Romania.
  
  
  OBJECTIVE
  A cross sectional study was conducted to assess the baseline predictors of liver disease evolution.
  
  
  METHODS
  83 HIV-HCV co-infected patients, untreated for HCV infection, were evaluated for viral replication, liver fibrosis (estimated by a noninvasive marker - FIB4), and plasma levels of IP-10 (interferon-gamma inducible protein 10) - a cytokine associated with an unfavorable outcome of HCV infection.
  
  
  RESULTS
  The median value for HCV viral load was high (6.3 log10 IU/mL), 98.8% of the patients were infected with HCV genotype 1. Although 53% of the patients received antiretroviral therapy (cART), only 31.8% of these achieved undetectable HIV levels. HCV viral load was significantly higher in patients with AIDS (6.4 vs. 6.1 log10IU/mL; P = 0.04), and in those naïve for cART (6.5 vs. 5.9 log10 IU/mL; P = 0.04). Severe fibrosis was directly correlated with immunosupression (56% vs. 17.4%, P = 0.03), HCV replication (6.1 vs. 4.9 log10IU/mL P = 0.008), and IP-10 median values (312 vs. 139 pg/ml, P=0.008). A serum IP-10 level higher than 400 pg/mL was significantly associated with FIB-4 median values (4.09 vs. 1.7, P = 0.004), HCV viral load (6.4 vs. 6.1 log10 IU/mL, P = 0.02) and ALT level (206.8 vs. 112.4 IU/L, P = 0.05).
  
  
  CONCLUSIONS
  An important part of the HIV-HCV co-infected patients had negative baseline predictors for the evolution of HCV infection; their therapeutical management must be conducted with special attention towards adherence and potential overlapping drug toxicities. High concentrations of plasma IP-10 are reliable markers for the severity of liver disease.
authors.affiliation: Department of Virology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania ; Emergent Disease Department, Stefan S. Nicolau Institute of Virology, Bucharest, Romania.
authors.forename: Camelia
authors.initials: C
authors.lastname: Sultana
authors.forename: Simona Manuela
authors.initials: SM
authors.lastname: Erscoiu
authors.forename: Camelia
authors.initials: C
authors.lastname: Grancea
authors.forename: Emanoil
authors.initials: E
authors.lastname: Ceausu
authors.forename: Simona
authors.initials: S
authors.lastname: Ruta
keywords: Biological Markers; Coinfection; Romania