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Reuters Health Information (2008-08-11): HCV not tied to poor immune restoration with antiretroviral therapy for HIV


HCV not tied to poor immune restoration with antiretroviral therapy for HIV

Last Updated: 2008-08-11 15:06:12 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Among patients with HIV started on antiretroviral therapy, co-infection with hepatitis C virus (HCV) does not appear to lessen gains in CD4 counts -- contrary to some previous reports.

As senior researcher Dr. Marina Nunez told Reuters Health, "Patients treated for HIV with active HCV infection should not have impaired immune restoration based on their HCV status."

In the July issue of Aids Research and Human Retroviruses, Dr. Nunez of Wake Forest University Health Sciences, Winston Salem, North Carolina and colleagues observe that there are conflicting reports on HIV/HCV patients receiving highly active antiretroviral therapy (HAART).

To investigate further, the researchers retrospectively studied data on 322 HIV patients within 3 years of first starting HAART. A total of 139 were positive for HCV RNA.

All patients achieved persistent HIV suppression. Use of nucleoside reverse transcriptase inhibitor (NRTI)-only regimens was associated with lesser gains in CD4 percentage over the study period. Use of zidovudine as part of the NRTI regimen was associated with greater gains.

Baseline CD4 count and being male predicted smaller increments in absolute CD4 cell counts. Higher baseline CD4 percentage and being older predicted lesser gains in CD4 percentage after 3 years of HAART.

At 1 year, a history of intravenous drug use was also associated with impaired immune restoration, but "seems not to have an impact beyond that time," say the investigators.

The team found no overall difference in CD4 restoration between patients co-infected with HCV and those who had HIV alone.

Thus, concluded Dr. Nunez, "Other factors need to be identified to explain the poor immune recovery observed in some patients who are adequately treated for their HIV infection."

Aids Res Hum Retroviruses 2008;24.

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