AIDS: a limited number of co-infection with HCV / HBV impact on the response to antiretroviral

Chronic viral hepatitis seems to have a limited impact on the response to antiretroviral therapy in patients infected with HIV impact, suggests an international study published in the journal "AIDS."

Highly active antiretroviral therapy (HAART) have increased the life expectancy of HIV patients, but in parallel, favored the contribution of co-morbidities, such as chronic hepatitis, as well as overall mortality and morbidity, to explain Phillip Law University of New South Wales in Sydney and colleagues.

HIV increases the risk of progression of hepatitis HBV or HCV, but the impact of hepatitis on the natural history of HIV remains poorly determined.

The researchers conducted a prospective study of 692 Thai patients in a trial of antiretroviral (study HIV-NAT, Netherlands Australia Thailand) for a period of one year.

The prevalence of co-infection with HBV was 8.7%, with 7.2% and HCV with HBV / HCV 0.4%.

The results show that the decrease in viral load was similar in the three groups (HIV, HIV / HBV and HIV / HCV), 1.5 log10 copies / ml in the middle between the fourth week and 48 weeks of treatment.

However, the analyzes indicate that co-infection with HIV and HBV or HCV is not associated with the likelihood of achieving an undetectable viral load.

The average increase in CD4 was significantly lower in patients co-infected with HIV / HBV and HIV / HCV compared to those infected with HIV only after four and eight weeks of treatment. But, after 48 weeks of treatment, the increase in CD4 cell count was similar in the three groups.

The analysis showed that being co-infected with HIV and HBV or HCV does not significantly reduce the chances of the CD4 count increase of 100 cells/mm3 at 48 weeks. Thus, 72% of patients infected with HIV, 70% of co-infected HIV / HBV and 66% of co-infected HIV / HCV achieved an increase of 100 CD4/mm3 after 48 weeks of treatment.

The risk of events related to the AIDS disease and the risk of death were also found similar in the three groups.

These results indicate that in a developing country like Thailand, HAART can improve the condition of HIV + patients, including those with co-morbidities such as chronic viral hepatitis, the authors conclude.