TY - JOUR
T1 - Changes in HIV RNA and CD4 cell count after acute HCV infection in chronically HIV-infected individuals
AU - ATHENA national observational cohort and the MOSAIC study
AU - Gras, Luuk
AU - de Wolf, Frank
AU - Smit, Colette
AU - Prins, Maria
AU - van der Meer, Jan T M
AU - Vanhommerig, Joost W
AU - Zwinderman, Aeilko H
AU - Schinkel, Janke
AU - Geskus, Ronald B
PY - 2015/4/15
Y1 - 2015/4/15
N2 - OBJECTIVE: Little is known about the impact of acute hepatitis C virus (HCV) co-infection on HIV-1 disease progression. We investigated CD4 cell count and HIV RNA concentration changes after HCV infection in individuals chronically infected with HIV-1.METHODS: We selected individuals that had the last negative and first positive HCV RNA test less than 1 year apart. Bivariate linear mixed-effects regression was used to model trends in HIV RNA level and CD4 cell count from 2 years before the last negative HCV RNA test until the first of the following dates: start of anti-HCV medication, change in combination antiretroviral therapy (cART) status, and end of follow-up.RESULTS: At the estimated time of HCV co-infection, of 89 individuals, 63 (71%) were cART-treated and 26 (29%) were not on cART. In persons on cART, median CD4 cell count declined from 587 to 508 cells per cubic millimeter (P < 0.0001) during the first 5 months after HCV infection and returned to 587 cells per cubic millimeter after 2.2 years. Also, the probability of an HIV RNA >50 copies per milliliter peaked to 18.6% at HCV co-infection, with lower probabilities 6 months before (3.5%, P = 0.006 compared with peak probability) and after (2.9%, P = 0.009). In persons not on cART, no significant impact of HCV co-infection on trends in the HIV RNA level or CD4 cell count was observed.CONCLUSIONS: Acute HCV infection in cART-treated, chronically HIV-infected patients was associated with a temporary decrease in CD4 cell counts and increased risk of HIV viremia >50 copies per milliliter. This may increase the risk of further HIV transmission.
AB - OBJECTIVE: Little is known about the impact of acute hepatitis C virus (HCV) co-infection on HIV-1 disease progression. We investigated CD4 cell count and HIV RNA concentration changes after HCV infection in individuals chronically infected with HIV-1.METHODS: We selected individuals that had the last negative and first positive HCV RNA test less than 1 year apart. Bivariate linear mixed-effects regression was used to model trends in HIV RNA level and CD4 cell count from 2 years before the last negative HCV RNA test until the first of the following dates: start of anti-HCV medication, change in combination antiretroviral therapy (cART) status, and end of follow-up.RESULTS: At the estimated time of HCV co-infection, of 89 individuals, 63 (71%) were cART-treated and 26 (29%) were not on cART. In persons on cART, median CD4 cell count declined from 587 to 508 cells per cubic millimeter (P < 0.0001) during the first 5 months after HCV infection and returned to 587 cells per cubic millimeter after 2.2 years. Also, the probability of an HIV RNA >50 copies per milliliter peaked to 18.6% at HCV co-infection, with lower probabilities 6 months before (3.5%, P = 0.006 compared with peak probability) and after (2.9%, P = 0.009). In persons not on cART, no significant impact of HCV co-infection on trends in the HIV RNA level or CD4 cell count was observed.CONCLUSIONS: Acute HCV infection in cART-treated, chronically HIV-infected patients was associated with a temporary decrease in CD4 cell counts and increased risk of HIV viremia >50 copies per milliliter. This may increase the risk of further HIV transmission.
KW - Adult
KW - Anti-Retroviral Agents/therapeutic use
KW - Antiretroviral Therapy, Highly Active/methods
KW - CD4 Lymphocyte Count
KW - Cohort Studies
KW - HIV Infections/complications
KW - HIV-1/isolation & purification
KW - Hepatitis C/diagnosis
KW - Humans
KW - Male
KW - Middle Aged
KW - RNA, Viral/blood
KW - Viral Load
U2 - https://doi.org/10.1097/QAI.0000000000000514
DO - https://doi.org/10.1097/QAI.0000000000000514
M3 - Article
C2 - 25559595
SN - 1525-4135
VL - 68
SP - 536
EP - 542
JO - Journal of acquired immune deficiency syndromes (1999)
JF - Journal of acquired immune deficiency syndromes (1999)
IS - 5
ER -