HCV coinfection is a major problem in HIV infected patients who contracted their infection through IVDU or blood products. The natural history and the histologic progression of HCV in HIV infected patients is not yet clearly defined. We studied biopsies of 18 HIV/HCV coinfected patients. This group was matched by age, sex, and duration of infection with a control group who were only HCV infected. Biopsies were examined by a single pathologist, who was blinded to the viral status of the patients. All biopsies were graded and staged according to a modified Knodell score. The patients were 14 males and 4 females in each group. There mean age was 42 ± 1 year. 75% were Caucasian, 11% Hispanic, 8% African American, and 6% other. IVDU was the risk factor for HCV group in 50% and 72% in the groups respectively. The mean duration of infection was 20 ± 1.4 years. Of the 18 coinfected patients 78% were receiving HAART therapy. At the time of biopsy 65%of the patients were HIV RNA < 400 and 83% had CD4 count >200.

Results: No difference in HAI score or fibrosis was detected between the two groups. HCV viral titers were similar in both groups.

In Summary: 1) HIV/HCV coinfected patients with stable HIV disease have similar histological disease as HCV infected patients. 2) HAART may play a role in slowing HCV disease progression which should be investigated.