HIV and Hepatitis.com Coverage of the
4th IAS Conference on HIV Pathogenesis, Treatment and Prevenion (IAS 2007)
 July 22-25, 2007, Sydney, Australia

Immunological Progression of HIV Disease in HIV-HCV Coinfected Patients on HAART

While studies have shown that HIV-HCV coinfected individuals tend to experience more rapid liver disease progression, there is conflicting data on the effect of hepatitis C on immunological progression of HIV disease.

In a study presented at the recent 4th International AIDS Society Conference on HIV Pathogenesis, Treatment, and Prevention in Sydney, Australia (July 22-25, 2007), researchers compare immunological progression in HIV-HCV coinfected patients who received treatment for hepatitis C.

The study included 57 HIV-HCV coinfected participants with undetectable HIV viral load at an outpatient clinic serving an urban population in Newark, NJ. All patients were treated with pegylated interferon alpha-2b (PegIntron) plus ribavirin.

CD4 and CD8 naive and memory T-cells were measured at baseline, at the end of anti-HCV therapy, and 24 weeks after completion of treatment. Only patients who maintained undetectable HIV RNA were followed through to the end of the study.

Results

  • Of the 57 patients who enrolled and began anti-HCV therapy, 18 were excluded from the analysis: 11 did not maintain undetectable HIV viral load, 3 discontinued due to adverse events, and 4 were lost to follow-up.

  • Of the remaining 39 patients, 13 achieved sustained virological response (SVR) and 26 experienced treatment failure.

  • Changes in naive and memory CD4 and CD8 cells were as follows:
    • Naive CD4 cell counts decreased by 8.15 cells in patients who experienced SVR and 26.20 cells in non-responders
    • Memory CD4 cell counts decreased by 19.80 cells and 33.10 cells, respectively.
    • Naive CD8 cell counts decreased by 16.80 cells and 48.50 cells, respectively.
    • Memory CD8 cells increased by 90.20 cells in patients with SVR and 15.80 cells in non-responders.

  • None of these differences was statistically significant.

Conclusion

“This study demonstrates that immunological progression of HIV as evidenced by a change in CD4 and CD8 naive and memory cells is not significantly influenced by treatment of hepatitis C coinfection,” the investigators concluded. “The effects of HCV therapy on T-cell counts are evident 24 weeks after completion of therapy.”

08/17/07

Reference
J Tolia, J Slim, J Fallon, and others. Immunological progression of HIV in a population of treated HCV co-infected patients. 4th International AIDS Society Conference on HIV Pathogenesis, Treatment, and Prevention. Sydney, Australia, July 22-25, 2007. Abstract MOPEB044.