A study to investigate the impact of the initiation of highly active antiretroviral therapy on the hepatitis C virus viral load in HIV/HCV-coinfected patients

Abstract

Changes in the hepatitis C virus (HCV) viral load (VL) were assessed in a retrospective study of 50 HIV/HCV-coinfected patients who initiated highly active antiretroviral therapy (HAART). Most patients responded to HAART [during the first 6 months, plasma HIV VL fell by a mean 1.39 log₁₀, becoming undetectable (<400 copies/ml) in 22% and CD4+ T cells increased by a mean of 100 cells/µl], but surprisingly, 27 (54%) showed some rise and 25 (50%) showed a significant increase in the HCV VL. This figure was considered to be a minimum estimate. A majority of the patients showed an increase of less than 1 log₁₀ that was associated with a rapid decrease in the HIV VL, whereas an increase in the HCV VL of greater than 1 log₁₀, noted in eight patients, was associated with a baseline CD4+ cell count of less than 200 cells/µl. The increase in the HCV VL was not associated with hepatitis as determined by raised alanine transferase.