Effect of HCV on disease progression in patients with HIV /HCV coinfection

Objective To analyze the effect of hepatitis C virus ( HCV) on disease progression in patients with human immunodeficiency virus ( HIV) /HCV coinfection. Methods Twenty- nine patients with HIV /HCV coinfection and 20 patients with HIV infection alone, who visited Beijing YouAn hospital for follow- up in August 2012, were enrolled. The two groups of patients were matched for age, sex, time and route of HIV infection, and HIV subtypes. The liver function and fibrosis were evaluated by biochemical testing of peripheral blood and FibroScan. CD4+and CD8+T cell counts were determined by flow cytometry. Results The levels of alanine aminotransferase, aspartate aminotransferase, and total bilirubin for the HIV /HCV coinfection group were 76. 16 ± 81. 25 U /L, 87. 66 ± 71. 32 U /L, and 14. 21 ± 9. 56μmol/L, respectively, significantly higher than those for the HIV infection group ( 27. 74 ±20. 63 U/L, 45. 65 ±16. 95 U/L, and 10. 26 ±3. 22 μmol /L) ( P = 0. 004, 0. 005, and 0. 046) . Compared with the HIV infection group, the HIV /HCV coinfection group had a nonsignificantly increased liver stiffness ( t = 1. 889, P = 0. 080) , a significantly higher viral load ( 3. 66 ± 0. 97 lg copies /ml vs 3. 02 ± 0. 90 lg copies /ml, t = 2. 251, P = 0. 030) , significantly lower CD4+T cell count and CD4+/CD8+ratio ( 374. 25 ± 185. 48 cells /μl vs 496. 45 ±230. 98 cells /μl, P = 0. 048; 0. 33 ± 0. 17 vs 0. 46 ± 0. 27, P = 0. 043) , and a nonsignificantly higher incidence of AIDS ( 27. 59% vs5. 00%, P = 0. 063) . Conclusion HCV exacerbates liver damage, enhances HIV replication, increases the impairment of immune function in patients with HIV /HCV coinfection, so it can accelerate the disease progression in these patients.