Author: Mark Mascolini
27 July 2010
Ongoing hepatitis C virus (HCV) replication stifles CD4-cell recovery in people with HIV, according to results of a Canadian prospective cohort study of people coinfected with HIV and HCV.
Although plentiful evidence indicates that uncontrolled HIV infection speeds progression of HCV disease, the impact of HCV on HIV is not as well understood. To address this knowledge gap, Canadian Co-infection Cohort Study investigators compared two groups of coinfected patients: 236 people with chronic HCV infection (persistent HCV RNA detection) and 35 with spontaneous HCV RNA clearance. The spontaneous clearance group differed from the chronic infection group only in markers of HCV disease.
CD4-cell recovery was 7 times slower in people with chronic HCV infection than in those who spontaneously cleared HCV. Adjusted change in absolute CD4 count stood at 4 cells/µL per year (95% confidence interval -0.6 to 8) in people with chronic HCV versus 26 cells/µL per year (95% confidence interval 12 to 41) in spontaneous controllers (P < 0.001).
Statistical analysis limited to people starting combination antiretroviral therapy yielded similar results. The investigators found a trend to greater CD4 declines before antiretroviral therapy began in the group with chronic HCV.
The researchers believe their results suggest “active HCV infection affects immune restoration even after years of antiretroviral therapy exposure.”
Source: Martin Potter, Adefowope Odueyungbo, Hong Yang, Sahar Saeed, Marina B. Klein, for the Canadian Co-infection Cohort Study Investigators. Impact of hepatitis C viral replication on CD4+ T-lymphocyte progression in HIV-HCV coinfection before and after antiretroviral therapy. AIDS. 2010; 24: 1857-1865.
For the study abstract
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