As reported in the April 2008 Journal
of Clinical Virology, researchers with the Women's Interagency HIV Study (WIHS)
conducted an analysis of the risk factors for and predictors of HCV viremia (detectable
viral load) among HIV positive and at-risk women.
The investigators looked
at socio-demographic, immunological, and virological factors associated with the
presence and level of HCV viremia in 1049 HCV seropositive women, of whom 882
were HIV positive and 167 were HIV negative at entry into the WIHS cohort.
Results
•
Plasma HCV RNA was detectable in 852 of the 1049 women (81%).
•
HCV viral loads ranged from 1.2 to 7.8 log10 copies/mL.
•
Women with detectable HCV viremia were more likely:
•
to have an HIV RNA level above 100,000 copies/mL (P = 0.0004); •
to report smoking (P = 0.01); •
to be of black race/ethnicity (P = 0.005).
•
However, they were less likely to have current or resolved hepatitis B virus (HBV)
infection.
•
HCV RNA levels were higher among women who were older than 35 years or were HIV
positive.
•
Current smoking and a history of drug use (crack/freebase cocaine, marijuana,
amphetamines, or heroin) were each associated with both the presence of and a
higher level of HCV viremia.
Conclusion
Based
on these findings, the study authors recommended, "Substance abuse counseling
aimed at eliminating ongoing use of illicit drugs and tobacco may reduce clinical
progression, improve response to treatment, and decrease HCV transmission by lowering
levels of HCV viremia in women.
4/18/08
Reference EA Operskalski,
WJ Mack, HD Strickler, and others. Factors associated with hepatitis C viremia
in a large cohort of HIV-infected and -uninfected women. Journal of Clinical
Virology 41(4): 255-263. April 2008.
