HIV-positive people with hepatitis C virus (HCV) experienced
progression to liver fibrosis if their HIV viral load rebounded above
1000 copies/mL or remained detectable on 2 consecutive tests,
researchers reported in the January edition of HIV Medicine
Smaller transient HIV "blips," however, were not associated with
worsening fibrosis. Optimized antiretroviral therapy, the study authors
suggested, may protect the liver.
HIV/HCV coinfected people are known to experience more rapid liver
fibrosis progression than people with hepatitis C alone, though the
reason for this is not fully understood. SMART
and other studies have shown that interruption of antiretroviral
therapy (ART) and lack of HIV viral suppression are associated with
liver, heart, and kidney disease, but it is not known what level of
viremia affects liver fibrosis progression.
Curtis Cooper and fellow investigators with the Canadian Co-infection
Cohort Study looked at the relationship between HIV viral load and
fibrosis progression in 288 HIV/HCV coinfected people in the cohort. A
majority (74%) were men, the mean age was 45 years, and the median CD4
T-cell count was 440 cells/mm3
. Most (81%) reported a history of injection drug use and half currently drank alcohol.
Labels: Canada, Coinfection, fibrosis progression, viral rebound