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Role of hepatitis C virus (HCV) viremia and HCV genotype in the immune recovery from highly active antiretroviral therapy in a cohort of antiretroviral-naive HIV-infected individuals.
Clin Infect Dis 2005; 40(12):e101-9CI

Abstract

BACKGROUND

The roles of hepatitis C virus (HCV) viremia and HCV genotype in the immune response to highly active antiretroviral therapy (HAART) are poorly understood. Our aim was to assess the CD4+ cell count recovery after HAART in human immunodeficiency virus (HIV)-infected patients with HCV viremia and HIV-infected patients who tested negative for HCV antibody (HCV-Ab). We also aimed to assess whether the response to HAART in these patients varied according to HCV genotype.

METHODS

The analysis focused on 1219 HCV-Ab-negative patients and 284 HCV-viremic patients from a cohort of HIV-infected subjects that includes persons who were antiretroviral naive before initiating HAART after cohort enrollment. HCV RNA load and HCV genotype were determined in plasma specimens obtained and stored during the 6-month period preceding the initiation of HAART.

RESULTS

The chance of achieving a CD4+ cell count increase of > or = 100 cells/microL from the pre-HAART level tended to be poorer in HCV-viremic patients than in patients who tested negative for HCV-Ab (adjusted relative hazard [RH], 0.82; 95% confidence interval [CI], 0.66-1.01; P = .06). In contrast, a comparison of patients who had a HCV RNA load >1 x 10(6) IU/mL with patients who had a HCV RNA load of 5-1 x 10(6) IU/mL revealed no significant association between HCV RNA load and achievement of an increased CD4+ cell count (adjusted RH, 0.97; 95% CI, 0.75-1.27; P = .83). There was no clear association between HCV genotype and the probability of achieving a CD4+ cell count increase.

CONCLUSIONS

An association between the presence of HCV-Ab and immune reconstitution after HAART has been shown elsewhere. Results of our large, prospective study support a direct role of HCV viremia in the CD4+ cell count response to HAART. Moreover, our results underline the fact that, in individuals coinfected with HIV and HCV, the goal of treating HCV infection is to eradicate HCV, to both slow the rate of HCV progression and limit potential interference with the response to HAART.

Authors+Show Affiliations

National Institute of Infectious Diseases, L. Spallanzani, Rome, Italy. antonucci@inmi.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15909251

Citation

Antonucci, Giorgio, et al. "Role of Hepatitis C Virus (HCV) Viremia and HCV Genotype in the Immune Recovery From Highly Active Antiretroviral Therapy in a Cohort of Antiretroviral-naive HIV-infected Individuals." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 40, no. 12, 2005, pp. e101-9.
Antonucci G, Girardi E, Cozzi-Lepri A, et al. Role of hepatitis C virus (HCV) viremia and HCV genotype in the immune recovery from highly active antiretroviral therapy in a cohort of antiretroviral-naive HIV-infected individuals. Clin Infect Dis. 2005;40(12):e101-9.
Antonucci, G., Girardi, E., Cozzi-Lepri, A., Capobianchi, M. R., De Luca, A., Puoti, M., ... Monforte, A. D. (2005). Role of hepatitis C virus (HCV) viremia and HCV genotype in the immune recovery from highly active antiretroviral therapy in a cohort of antiretroviral-naive HIV-infected individuals. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 40(12), pp. e101-9.
Antonucci G, et al. Role of Hepatitis C Virus (HCV) Viremia and HCV Genotype in the Immune Recovery From Highly Active Antiretroviral Therapy in a Cohort of Antiretroviral-naive HIV-infected Individuals. Clin Infect Dis. 2005 Jun 15;40(12):e101-9. PubMed PMID: 15909251.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of hepatitis C virus (HCV) viremia and HCV genotype in the immune recovery from highly active antiretroviral therapy in a cohort of antiretroviral-naive HIV-infected individuals. AU - Antonucci,Giorgio, AU - Girardi,Enrico, AU - Cozzi-Lepri,Alessandro, AU - Capobianchi,Maria Rosaria, AU - De Luca,Andrea, AU - Puoti,Massimo, AU - Petrelli,Enzo, AU - Carnevale,Giuseppe, AU - Rizzardini,Giuliano, AU - Grossi,Paolo Antonio, AU - Viganò,Paolo, AU - Moioli,Maria Cristina, AU - Carletti,Fabrizio, AU - Solmone,Mariacarmela, AU - Ippolito,Giuseppe, AU - Monforte,Antonella D'Arminio, AU - ,, AU - ,, Y1 - 2005/05/05/ PY - 2004/12/28/received PY - 2005/02/11/accepted PY - 2005/5/24/pubmed PY - 2006/9/19/medline PY - 2005/5/24/entrez SP - e101 EP - 9 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin. Infect. Dis. VL - 40 IS - 12 N2 - BACKGROUND: The roles of hepatitis C virus (HCV) viremia and HCV genotype in the immune response to highly active antiretroviral therapy (HAART) are poorly understood. Our aim was to assess the CD4+ cell count recovery after HAART in human immunodeficiency virus (HIV)-infected patients with HCV viremia and HIV-infected patients who tested negative for HCV antibody (HCV-Ab). We also aimed to assess whether the response to HAART in these patients varied according to HCV genotype. METHODS: The analysis focused on 1219 HCV-Ab-negative patients and 284 HCV-viremic patients from a cohort of HIV-infected subjects that includes persons who were antiretroviral naive before initiating HAART after cohort enrollment. HCV RNA load and HCV genotype were determined in plasma specimens obtained and stored during the 6-month period preceding the initiation of HAART. RESULTS: The chance of achieving a CD4+ cell count increase of > or = 100 cells/microL from the pre-HAART level tended to be poorer in HCV-viremic patients than in patients who tested negative for HCV-Ab (adjusted relative hazard [RH], 0.82; 95% confidence interval [CI], 0.66-1.01; P = .06). In contrast, a comparison of patients who had a HCV RNA load >1 x 10(6) IU/mL with patients who had a HCV RNA load of 5-1 x 10(6) IU/mL revealed no significant association between HCV RNA load and achievement of an increased CD4+ cell count (adjusted RH, 0.97; 95% CI, 0.75-1.27; P = .83). There was no clear association between HCV genotype and the probability of achieving a CD4+ cell count increase. CONCLUSIONS: An association between the presence of HCV-Ab and immune reconstitution after HAART has been shown elsewhere. Results of our large, prospective study support a direct role of HCV viremia in the CD4+ cell count response to HAART. Moreover, our results underline the fact that, in individuals coinfected with HIV and HCV, the goal of treating HCV infection is to eradicate HCV, to both slow the rate of HCV progression and limit potential interference with the response to HAART. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/15909251/Role_of_hepatitis_C_virus__HCV__viremia_and_HCV_genotype_in_the_immune_recovery_from_highly_active_antiretroviral_therapy_in_a_cohort_of_antiretroviral_naive_HIV_infected_individuals_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/430445 DB - PRIME DP - Unbound Medicine ER -