[TuPe1.1C05] Effect of Hepatitis C infection on immunologic and virologic response among persons with HIV infection initiating highly active antiretroviral therapy (HAART)

3rd International AIDS Society Conference on HIV Pathogenesis and Treatment

Rio de Janeiro - July 24 - 27, 2005

EFFECT OF HEPATITIS C INFECTION ON IMMUNOLOGIC AND VIROLOGIC RESPONSE AMONG PERSONS WITH HIV INFECTION INITIATING HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART)

IAS Conf HIV Pathog Treat 2005 Jul 24-27;3rd: Abstract No. TuPe1.1C05

Sullivan P.¹, Hanson D.¹, Teshale E.¹, Wotring L.²
¹Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America, ²Michigan Department of Community Health, Detroit, Michigan, United States of America

INTRODUCTION: Hepatitis C (HCV) co-infection is common among persons with HIV; progression of HCV disease is accelerated in persons with HIV. However, it is unclear how HCV infection affects the course of HIV disease among persons on HAART.

METHODS: Data were from the Adult and Adolescent Spectrum of HIV Disease Project collected in over 100 clinics in 10 US states. We analyzed data from therapy-naïve persons initiating HAART from 1998 to 2003. We estimated slopes of viral load (VL) and CD4 count (CD4) change during time after HAART initiation using a random effects regression model, and tested the hypothesis that change in VL during the first 30 days, or proportional change from baseline CD4 for up to 1 year after HAART initiation, was different in persons with (HCV+) or without (HCV-) HCV.

RESULTS: Among 1531 persons initiating HAART, 268 (18%) had HCV. Median baseline VL was 4.9 log (HCV-) versus 5.0 log (HCV+; p=0.5). Change in VL during the 30 days after HAART initiation was -0.06 log/day (HCV-) versus -0.07 log/day (HCV+; p=0.14). Median baseline CD4 was 221 cells/µl for HCV- and 180 cells/µl HCV+ (p=0.009); the proportional increase in CD4 after HAART initiation was not different between HCV- (+24%/month) and HCV+ (+21%/month; p=0.52). Among 301 persons previously diagnosed with alcoholism, the proportional CD4 increase for 101 HCV+ persons (+10%/month) was significantly less than the increase for 200 HCV- persons (+19%/month; p=0.02).

CONCLUSIONS: In our cohort, prevalent HCV infection was not associated with attenuated virologic or immunologic response after HAART initiation, except among persons with previously diagnosed alcoholism. Although HCV infection may adversely impact progression of HIV disease, it does not appear to lessen response to HAART in the first year after initiation. Understanding durability of VL suppression and long term trends in CD4 for those with HCV is important.

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Clinical | TuPe1.1C05 | Patrick Sullivan
Hepatitis viruses

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