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Hepatitis C Doesn't Impair CD4 Recovery in HIV Context

Those with both infections on anti-retrovirals didn't have poorer CD4 restoration due to HCV

TUESDAY, July 29 (HealthDay News) -- Coinfection with hepatitis C virus does not reduce CD4 recovery in subjects with HIV who are receiving highly active anti-retroviral therapy, according to research published in the July AIDS Research and Human Retroviruses.

Kari Yacisin of Wake Forest University Health Sciences in Winston-Salem, N.C., and colleagues analyzed data from 322 treatment-naive individuals with persistent HIV suppression after initiation of highly active anti-retroviral therapy (HAART). Of this group, 139 had positive hepatitis C virus RNA and 183 were infected with HIV only. Mean time to follow-up was 34 months.

Lower baseline CD4 count was the strongest factor associated with larger CD4 gains over the study period. In multivariate analyses, hepatitis C coinfection wasn't associated with poorer CD4 restoration. At one year of HAART, a history of intravenous drug use was associated with smaller gains in absolute CD4 counts.

"While some studies suggest that HIV/HCV-coinfected patients might have an impaired immune response under HAART compared to HIV-monoinfected subjects, other studies do not support those findings," the authors write. " In summary, HCV replication per se does not impair CD4 restoration in HIV-infected patients successfully treated with antiretroviral therapy. Lower baseline CD4 counts are the strongest predictors of greater CD4 gains over a 3-year period, while a history of IVDU (intravenous drug use) negatively affects CD4 restoration only early after the initiation of therapy."

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