Relationship of hepatitis C viremia to HIV state and to infection by specific hepatitis C genotypes

Abstract

Infection by specific HCV genotypes (type 3 in HIV-infected patients and by type 1 in HIV-non infected ones) implies a higher risk of HCV viremia, whereas multiple HCV types infection is negatively associated with this probability. HIV coinfection does not influence the probability of HCV viremia.

The Association of Human Immunodeficiency Virus Infection with Spontaneously Resolved Hepatitis C Virus Infection and Level of Viremia Among Injection Drug Users

“…A vigorous host CD4/CD8 T-lymphocyte reponse is likely important in controlling HCV RNA levels and HIV-coinfected patients have been shown to mount a less vigorous T-cell response to HCV than monoinfected patients [27,28]. Although some investigators have demonstrated an inverse relationship between CD4 T-cell count and HCV RNA levels [5,14], our results and those of others did not show this [29,30]. CD4 T-cell count alone may be an incomplete measure of the quality of the immune response in HIV infection as evidenced by opportunistic infections such as tuberculosis occurring at CD4 cell counts >200 cells/ml.…”

“…Immune competence has been hypothesized to be central to the spontaneous resolution of HCV and control of HCV viremia [7,8]. Nevertheless, whether and how HIV infection and HIV-related factors, e.g., CD4 T-cell count, HIV viral load, and the use of and response to HIV antiretroviral therapy (ART), are associated with spontaneously resolved HCV infection and HCV RNA levels in persistent HCV infection among IDUs is controversial [5,[9][10][11][12][13][14][15]. The virological characteristics and epidemiology of HCV in HIV-coinfected IDUs are of increasing clinical importance, as more coinfected patients are presenting for HCV care and consideration for HCV antiviral therapy.…”

Fibrosis is worse in HIV-HCV patients with low-level immunodepression referred for HCV treatment than in HCV-matched patients

“…The potential role of HCV genotype posited by a few authors is unlikely in our study, because the distribution was not different between the 2 groups. 5,32,33 In conclusion, liver fibrosis is worse in HIV-HCV patients than in HCV patients, even with low-level immunodepression, justifying early treatment against HCV. In this setting of coinfection, both fibrous septa and perisinusoidal fibrosis are more abundant, so we recommend the use of adequate special stains (trichrome stain plus picrosirius red or Gordon and Sweet's stain) for histological examination of biopsy specimens.…”

Comparison of Hepatitis C Viral Loads in Patients with or without Coinfection with Different Genotypes

“…However, a direct relationship between the level of viremia and either the severity of liver disease or transaminase levels is not universally accepted (10,11). Besides, the roles of HCV genotype, human immunodeficiency virus (HIV) coinfection, age, race, and sex have been investigated in this respect, with various results (1,2,(15)(16)(17)22).…”