Reuters Health Information (2005-11-16): Hepatitis C virus persists in genital tract of HIV+ women
Hepatitis C virus persists in genital tract of HIV+ women
Last Updated: 2005-11-16 16:38:44 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Hepatitis C virus (HCV) RNA
is often present in the genital tracts of women coinfected with HCV and
HIV, according to a report in the November 1st issue of The Journal of
"Perinatal and sexual transmission of HCV may be related to the
presence of HCV in the genital tract," Dr. Andrea Kovacs from the
University of Southern California, Los Angeles, told Reuters Health.
"Thus, it would be important to counsel co-infected patients in regards
to potential transmission to a partner or a newborn."
Dr. Kovacs and colleagues analyzed cervicovaginal lavage fluid from
71 women, 58 of whom were coinfected with HCV and HIV, participating in
the Women's Interagency HIV Study.
Nearly one third of the samples from HCV/HIV-coinfected women
(18/58, 31%) contained HCV RNA, the researchers report, although the
viral loads were relatively low (median, 1500 copies/mL).
None of the women who were infected with HCV but not with HIV had
detectable HCV RNA in their cervicovaginal lavage fluid when tested by
a commercial HCV RNA assay, the results indicate, but two of these
women had detectable HCV RNA by the researchers' in-house qualitative
The only statistically significant predictors of HCV RNA in
cervicovaginal lavage fluid were the presence of HCV RNA in plasma and
the presence of HIV RNA in lavage fluid, the researchers note.
Careful analysis of HCV from five women suggested the presence of
differing quasispecies variants in these compartments. In three women,
cervicovaginal-derived HCV contained sequences that were not present in
HCV derived from plasma or peripheral blood mononuclear cells, the
"To our knowledge," the investigators write, "our study is the first
to demonstrate compartmentalization of HCV in the genital tracts of
HCV/HIV-coinfected women and possible local replication in a large
proportion of HCV/HIV-coinfected women."
"HCV appears to infect cells in compartments other than hepatic and
blood," Dr. Kovacs said. "Thus, further study will be needed to assess
the impact of such reservoirs on reactivation of HCV."
"Additionally, with treatment of HCV and HIV it would be important
to assess for reservoirs, such as the genital tract, to assure that
there are no sanctuaries where HCV can replicate independently from the
blood compartment," Dr. Kovacs concluded.
J Infect Dis 2005;192:1557-1565.