Coinfection Does Not Impair Virological or Immunological Response
to Antiretroviral Therapy
HIV positive patients coinfected with hepatitis C
virus (HCV) achieved HIV viral load suppression and
CD4 cell recovery on antiretroviral therapy similar
to that of people with HIV alone, according to a study
from China described in the June
1, 2010 Journal of Acquired Immune Deficiency Syndromes.
Coinfected individuals with detectable HCV antibodies
and HCV RNA, however, appeared more likely to experience
certain antiretroviral side effects.
people do not respond as well, on average, to interferon-based
therapy for chronic hepatitis C, but research on response
to HIV treatment
has been mixed; some studies have found coinfected patients
tend to experience smaller CD4 T-cell gains, but others have
seen no difference.
the present analysis, Guo Fuping from the Chinese Academy of
Medical Sciences in Beijing and colleagues assessed the influence
of HCV coinfection on treatment of HIV patients receiving highly
active antiretroviral therapy (HAART) regimens containing nevirapine
(Viramune), a drug that can cause hypersensitivity reactions
characterized by skin rash and liver toxicity.
study enrolled 175 HIV positive antiretroviral-naive Chinese
adults who started HAART and attended follow-up visits during
2005-07. Participants were grouped according to HCV status;
117 were HCV antibody negative, 24 were HCV antibody positive
but HCV RNA negative, and 34 were positive on both tests. The
researchers collected data on clinical, virological, and immunological
responses, as well as adverse events.
who were both HCV antibody positive and HCV RNA positive
had a significantly higher incidence of rash and liver toxicity
than people who were HCV antibody negative or HCV antibody
positive but HCV RNA negative.
was no statistically significant difference in HIV viral
load suppression among the 3 groups.
and CD8 T-cell responses were also similar across all 3
Based on these findings, the study authors concluded, "HCV/HIV
coinfection does not affect immunological and virological responses
However, they continued, patients with positive serum HCV antibodies
and HCV RNA had worse adverse drug reactions to HAART such as
rash and hepatotoxicity.
Investigator affiliation: Department of Infectious Disease,
Peking Union Medical College Hospital, Chinese Academy of Medical
Sciences, Beijing, China.
G Fuping, LV Wei, H Yang, and others. Impact of Hepatitis C
Virus Coinfection on HAART in HIV-Infected Individuals: Multicentric
Observation Cohort. Journal of Acquired Immune Deficiency
Syndromes 54(2): 137-142 (Abstract).
June 1, 2010.