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Relation between HIV-1 and hepatitis C viral load in patients with hemophilia

  1. Author:
    Daar, E. S.
    Lynn, H.
    Donfield, S.
    Gomperts, E.
    Hilgartner, M. W.
    Hoots, W. K.
    Chernoff, D.
    Arkin, S.
    Wong, W. Y.
    Winkler, C. A.

  2. Author Address

    Cedars Sinai Med Ctr, Div Infect Dis, 1130E, 8700 Beverly Blvd, Los Angeles, CA 90048 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. Cedars Sinai Burns & Allen Res Inst, Dept Med, Div Infect Dis, Los Angeles, CA USA. Rho Inc, Chapel Hill, NC USA. Childrens Hosp Los Angeles, Los Angeles, CA 90027 USA. New York Hosp, Cornell Med Ctr, Div Pediat Hematol & Oncol, New York, NY USA. Univ Texas, Sch Med, Dept Pediat, Houston, TX USA. Univ Texas, Sch Med, Dept Internal Med, Houston, TX USA. Chiron Corp, Emeryville, CA 94608 USA. Schneider Childrens Hosp, Div Pediat Hematol Oncol & Stem Cell Transplantat, New Hyde Park, NY USA. NCI, SAIC, Frederick Canc Res & Dev Ctr, Frederick, MD 21701 USA.
    1. Year: 2001
  2. Journal: Journal of acquired immune deficiency syndromes (1999)
    1. 26
    2. 5
    3. Pages: 466-472
  4. Type of Article: Article
  1. Abstract:

    Coinfection with hepatitis C virus (HCV) and HIV-1 is common in patients with hemophilia and in intravenous drug users. Little, however, is known about the relation between HIV-1 and HCV coinfection and the effects on HCV clearance and pathogenesis. We examined data from 207 HIV-1-infected and 126 HIV-1- uninfected patients with hemophilia enrolled in the multicenter Hemophilia Growth and Development Study. Participants were observed during prospective follow-up for approximately 7 years with annual measurements of alanine aminotransferase (ALT), CD4(+) cells, and HCV and HIV-1 RNA levels. Clearance of HCV was more likely to occur in those uninfected with HIV-1 (14.3 versus 2.5%; odds ratio [OR] 4.79: 95% confidence interval [CI], 1.63-14.08. p = .005) and was more common with decreasing age (OR, 1.23; 95% CI, 1.04-1.47; p = .017). HCV RNA levels were higher throughout the 7 years of follow-up in those HIV-1- infected (p < .001). In the HIV-1-infected participants, baseline CD4(+) cells were inversely related to HCV RNA with every 100-cell increase associated with a 0.19 log(10) copy/ml decrease in HCV RNA (p = .002), and HIV-1 and HCV RNA levels were directly related (p = .008). Increasing HCV RNA levels were also associated with significantly higher ALT levels regardless of HIV-1 infection status. These results demonstrate that HIV-1/HCV coinfection is associated with a reduced likelihood of HCV clearance and that higher levels of HCV RNA are associated with increased hepatic inflammation.

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