title: High serum HCV RNA in chronic hepatitis C patients coinfected with HIV despite successful antiretroviral therapy.
abstract: Baseline serum HCV RNA predicts treatment success in chronic hepatitis C patients. Thresholds at 0.8, 2, 4 and 6 million IU/ml discriminate treatment outcomes using distinct antiviral regimens. Compared to the general population, immunosuppressed individuals exhibit greater viral load values. This has been confirmed in HIV-HCV-coinfected patients, although little is known about the influence of antiretroviral therapy.
  
  
  
  Serum HCV RNA results recorded from all chronic hepatitis C patients who consecutively attended at our clinic were analysed.
  
  
  
  A total of 813 patients with detectable HCV RNA were identified. HIV coinfection was present in 78.7%, of whom 91% were on antiretroviral therapy. Overall, 467 (57%), 273 (34%), 170 (21%) and 127 (16%) had HCV RNA >0.8, >2, >4 and >6 million IU/ml, respectively. These high viral load values were found in 60%/36%/23%/18% of HIV-positive versus 47%/25%/11%/6% of HIV-negative individuals (P<0.01), respectively. In multivariate analysis, the greatest HCV RNA values were only significantly associated with HIV coinfection and HCV genotypes-1 or -4. Greater HCV RNA values were paradoxically found in HIV patients on than off antiretroviral therapy.
  
  
  
  Serum HCV RNA values above 0.8, 2, 4 and 6 million IU/ml are roughly seen in 47%, 25%, 11% and 6% of chronic hepatitis C monoinfected patients, respectively. Despite being on antiretroviral therapy, the corresponding figures are 1.3- to 3.0-fold greater in HIV-HCV-coinfected patients, who may benefit less frequently from shorter oral HCV treatment lengths.
authors.affiliation: Infectious Diseases Unit, La Paz University Hospital, Madrid, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Barreiro
authors.affiliation: Department of Internal Medicine, Milagrosa Clinic, Madrid, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Labarga
authors.affiliation: Puerta de Hierro Research Institute & University Hospital, Majadahonda, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: de Mendoza
authors.affiliation: Puerta de Hierro Research Institute & University Hospital, Majadahonda, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Benítez-Gutiérrez
authors.affiliation: Department of Infectious Diseases, University Hospital Crosshouse, Kilmarnock, Scotland, UK.
authors.forename: José V
authors.initials: JV
authors.lastname: Fernandez-Montero
authors.affiliation: Infectious Diseases Unit, La Paz University Hospital, Madrid, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Peña
authors.affiliation: Infectious Diseases Unit, La Paz University Hospital, Madrid, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Soriano
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D060085:Coinfection / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000188:drug therapy / Q000276:immunology / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood* / Q000235:genetics; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D000998:Antiviral Agents; D012367:RNA, Viral