Joshua
Lunior, 24, of Accord, N.Y., is an HIV-positive hemophiliac who was diagnosed
with the virus when he was 4 1/2 years old.
Graphic
Permission Granted, 2007 Gannett Co. Inc.
In
the early years of the AIDS epidemic, many people with hemophilia were infected
with HIV before it was known that the virus
could be transmitted through blood products, including replacement clotting factors.
As
reported in the July 31, 2007 issue of AIDS, researchers concluded a study
to identify correlates of spontaneous hepatitis C virus
(HCV) clearance among HIV positive hemophiliacs.
The investigators
used data from detailed questionnaires to identify the likely dates of primary
HCV and HIV infection and to categorize the participants' sex, race, alcohol use,
history of interferon-based therapy,
hepatitis B virus (HBV) status, as well as HIV/AIDS
disease history, treatment, and
current status.
Spontaneous HCV clearance was defined as non-detection
of HCV RNA by polymerase chain reaction (PCR) assay in paired annual plasma samples,
excluding those treated with interferon.
Results
•
Among 478 HIV positive subjects, 61 (12.8%) had cleared HCV.
•
Among the 31 participants
with both HIV and chronic HBV infection, 16 (51.6%) had cleared HCV.
•
In HIV positive subjects
with chronic HBV, the likelihood of HCV clearance was 11.2-fold greater after
adjusting for sex, race, and hemophilia severity. •
Excluding participants
with chronic HBV, the overall prevalence of spontaneous HCV clearance was 10.1%.
•
Compared with the overall
rate, spontaneous clearance occurred significantly less often among men (9.7%;
P = 0.05), blacks (1.6%; P = 0.01), and participants with severe hemophilia (8.2%;
P = 0.02).
•
HCV clearance was not
associated with alcohol consumption, detectable plasma HIV RNA, CD4 cell count,
use of anti-HIV therapy, AIDS history, or age at or duration of HIV or HCV infection.
Conclusion
In
conclusion, the authors wrote, "HCV clearance is unambiguously and markedly
increased with chronic HBV infection among HIV coinfected people."
National
Cancer Institute, National Institutes of Health, Rockville, MD; National Center
for HIV, Hepatitis, STD, and TB Prevention, Centers for Disease Control, Atlanta,
GA; University of Pennsylvania, Philadelphia, PA; Research Triangle Institute
International, Rockville, MD; Epidemiology Branch, DPS/OSB/CDRH, FDA, Rockville,
MD; University of New Mexico, Albuquerque, NM; Pennsylvania State University College
of Medicine, Hershey, PA.
08/28/07
Reference L
Melendez-Morales, BA Konkle, L Preiss, and others. Chronic hepatitis B and other
correlates of spontaneous clearance of hepatitis C virus among HIV-infected people
with hemophilia. AIDS 21(12): 1631-1636. July 31, 2007.
