The Relationship between Hepatitis C Virus and HIV Infection in Hemophiliacs

The Relationship between Hepatitis C Virus and HIV Infection in Hemophiliacs.

E Daar from Cedars-Sinai and UCLA, D Chernoff with Chiron, Hoots from Cornell, Wong from My Sinai, and others reported on this study suggest that Hepatitis C may increase progression of HIV. HCV viral load increases resulted in an increase in HIV viral load. Although a few studies have suggested that HCV can speed progression of HIV, doubts persist because there hasn't been much information supporting this notion. As well, the results show that HIV increased HCV-RNA viral load. But its generally accepted that HIV increases HCV progression. increased progression This study was intended to explore the relationship between these pathogens.

Daar studied 207 HIV-infected and 121 uninfected hemophiliacs with HCV infection who in 1989-90 enrolled in the Hemophilia Growth and Development Study. CD4 counts and plasma HCV-RNA were measured annually in all subjects, and plasma HIV-RNA was measured annually in the HIV-infected subjects through 1997. HIV and HCV RNA were measured using bDNA version 2.0 assays (Chiron, Emeryville, CA); the lower limits of detection = 500 copies/ml and 200,000 eq/ml, respectively.

Study findings:

HCV-RNA was higher among HIV-infected hemophiliacs than in uninfected hemophiliacs, ranging from 0.8 to 0.62 log eq/ml (p<0.001) from baseline to year 7.

HCV-RNA decreased by 0.16 log eq/ml [95% CI=(0.05,0.28), p=0.006] for every 100 cell increase in baseline CD4s.

HCV-RNA increased by 0.14 [95% CI=(0.06,0.23), p=0.001] eq/ml for every 3-fold increase in baseline HIV-RNA.

After controlling for HIV RNA, CD4s and anti-retroviral therapy, every 10-fold increase in baseline HCV RNA resulted in a 1.60-fold increase in the relative hazard [95% CI=(1.07,2.38), p=0.02] of progression to AIDS.

The authors conclude the study suggests that HCV RNA may be an independent predictor of HIV clinical progression.