Impact of HIV Protease Inhibitors on HCV Viremia - National AIDS Treatment Advocacy Project - NATAP

Impact of HIV Protease Inhibitors on HCV Viremia

(ICAAC abstract I-165), authors: OT Ruschmann, B Hirschel, L Perrin and others, Univ Hosp, Geneva, Switz.

The authors of this study said co-infection with HIV and HCV is associated with increased HCV RNA. However, the authors of abstract I-167 said some studies have suggested that chronic hepatitis C could be more severe in HIV infected individuals and others have failed to find evidence to support this hypothesis.

The aim of this study was to explore the effect of protease therapy on HCV viremia. Nineteen IVDUs coinfected with HIV and HCV were prospectively followed. All had progressive HIV and were treated with a protease inhibitor (ritonavir-9, indinavir-7, ritonavir+saquinavir-3) and 2 nucleosides. HIV RNA (Roche Amplicor), CD4, CD8, and HCV RNA were measured at baseline and weeks 6, 17, and 32.

Authors concluded that although there was an initial increase in HCV viremia noted at week 6, there was little change in HCV viremia in subsequent follow-up to 32 weeks. Authors also noted there was no decrease on HCV viremia despite the improvement of immune functions.

	Baseline	wk 6	wk 17	wk 32	P wk 6 vs base	P wk 32 vs base
HCV RNA	5.3	+0.4	-0.2	-0.1	.003	.52
HIV RNA	5.0	-2.1	-2.4	-2.6	.0001	.0003
CD4	63	+73	+89	+115	.002	.001
CD8	456	+295	+224	+193	.001	.05

Baseline and changes in HCV and HIV RNA are expressed in log. 5.3 log is about 199,000 copies/ml; 5.0 log is 100,000 copies/ml.