Skip Navigation LinksHome > December 2009 - Volume 52 - Issue 4 > Hepatitis C Viral Kinetics During Treatment With Peg IFN-alp...
JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/QAI.0b013e3181be7249
Clinical Science

Hepatitis C Viral Kinetics During Treatment With Peg IFN-alpha-2b in HIV/HCV Coinfected Patients as a Function of Baseline CD4+ T-Cell Counts

Avidan, Neumann U PhD*†‡; Goldstein, Deborah MD§; Rozenberg, Lynn MSc*; McLaughlin, Mary RN†; Ferenci, Peter MD¶; Masur, Henry MD‖; Buti, Maria MD#; Fauci, Anthony S MD†; Polis, Michael A MD, MPH†; Kottilil, Shyam MD, PhD†

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Abstract

Background: HIV/hepatitis C virus (HCV) coinfected patients are known to have lower sustained viral response (SVR) rates than HCV monoinfected patients. However, the role of CD4+ T-cell counts on viral kinetics and outcome is not fully understood.

Methods: HCV RNA kinetics (bDNA v3, lower limit of detection [LD] = 615 IU/mL) was analyzed in 32 HIV/HCV coinfected persons treated with Pegylated-interferon-α2b (1.5 μg/kg weekly) and ribavirin (1-1.2 g daily) for 48 weeks and compared with results obtained from 12 HCV monoinfected patients treated with the same regimen.

Results: Baseline CD4+ T-cell counts ≥450 cells/mm3 were significantly (P < 0.002) associated with SVR in coinfected genotype 1 patients. First phase decline was significantly lower among patients with low as compared with high CD4 counts (P < 0.03) and among coinfected compared with monoinfected patients (P < 0.002). Second phase decline slope showed a similar trend for coinfected patients.

Conclusions: Low baseline CD4+ T-cell count is associated with slower HCV viral kinetics and worse response to treatment among HIV coinfected patients, suggesting HCV treatment response depends on immune status. HCV genotype 1 coinfected patients have slower first phase viral kinetics than HCV monoinfected patients. First phase viral decline (>1.0 log) and second phase viral decline slope (>0.3 log/wk) are excellent predictors of SVR for coinfected patients.

© 2009 Lippincott Williams & Wilkins, Inc.

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