Coinfection

Detectable HCV in Peripheral Blood Cells after Interferon-based Therapy Predicts Relapse in HIV-HCV Coinfected Patients

Traditionally, individuals treated for chronic hepatitis C virus (HCV) infection who maintain undetectable HCV RNA (genetic material) in their blood 6 months after completing therapy are defined as achieving sustained virological response (SVR). It is not clear how the presence of HCV in the liver and elsewhere in the body affects the likelihood of sustained treatment response versus relapse, especially in HIV positive people.

As reported in the August 28, 2008 advance online edition of the Journal of Viral Hepatitis, Spanish investigators analyzed the association between treatment outcomes and the presence of positive/negative strand HCV RNA in different subsets of peripheral blood cells in 34 HIV-HCV coinfected patients who completed 48 weeks of treatment with pegylated interferon plus ribavirin.

Positive/negative strand HCV RNA was detected by amplification of the 5' untranslated region (5' UTR) using high-temperature RT-PCR in immunomagnetic-isolated cell subsets.

Results

• Multivariate analysis showed that of 3 variables, only the presence of positive/negative strand HCV RNA was independently associated with relapse (odds ratio 14; P = 0.024).

• 23 patients (67.6%) achieved SVR, while 11 (32.4%) experienced HCV relapse.

• Positive/negative strand HCV RNA was detected significantly less frequently in patients with SVR compared with relapsers (8.6% vs 63.6%; P = 0.002).

• Baseline HCV viral load was significantly higher among patients who relapsed (P = 0.008).

• Patients who achieved SVR were more likely to have very early virological response compared with relapsers (P = 0.003).

In conclusion, the study authors wrote, "the presence of positive/negative strand HCV RNA at the end of treatment is associated with relapse among HCV-HIV coinfected patients and might have important implications in the clinical practice."

10/07/08

Reference

B De Felipe, M Leal, N Soriano-Sarabia, and others. HCV RNA in peripheral blood cell subsets in HCV-HIV coinfected patients at the end of PegIFN/RBV treatment is associated with virologic relapse. Journal of Viral Hepatitis. August 28, 2008 [Epub ahead of print].