Spontaneous Viral Clearance, Viral Load, and Genotype Distribution of Hepatitis C Virus (HCV) in HIV-Infected Patients with Anti-HCV Antibodies in Europe

October 17, 2008

J Infect Dis. 2008 Nov 1;198(9):1337-1344.

Spontaneous Viral Clearance, Viral Load, and Genotype Distribution of Hepatitis

C Virus (HCV) in HIV-Infected Patients with Anti-HCV Antibodies in Europe.

Soriano V, Mocroft A, Rockstroh J, Ledergerber B, Knysz B, Chaplinskas S, s

L, Karlsson A, Katlama C, Toro C, Kupfer B, Vogel M, Lundgren J; for the

EuroSIDA Study Group.

1Service of Infectious Diseases, Hospital III, Madrid, Spain; 2Royal Free

and University College Medical School, London, United Kingdom; 3Department of

Medicine I, University of Bonn, Bonn, Germany; 4Division of Infectious Diseases,

Department of Medicine, University Hospital, Zurich, Switzerland; 5Department of

Infectious Diseases, Wroclaw Medical University, Wroclaw, Poland; 6Lithuanian

AIDS Center, Vilnius, Lithuania; 7Copenhagen HIV Program, Copenhagen, Denmark;

8Karolinska University Hospital, Stockholm, Sweden; 9Pitié-Salpêtrière Hospital,

Paris, France.

Background. @nbsp; Variables influencing serum hepatitis C virus (HCV) RNA

levels and genotype distribution in individuals with human immunodeficiency

virus (HIV) infection are not well known, nor are factors determining

spontaneous clearance after exposure to HCV in this population. Methods. @nbsp;

All HCV antibody (Ab)-positive patients with HIV infection in the EuroSIDA

cohort who had stored samples were tested for serum HCV RNA, and HCV genotyping

was done for subjects with viremia. Logistic regression was used to identify

variables associated with spontaneous HCV clearance and HCV genotype 1. Results.

@nbsp; Of 1940 HCV Ab-positive patients, 1496 (77%) were serum HCV RNA positive.

Injection drug users (IDUs) were less likely to have spontaneously cleared HCV

than were homosexual men (20% vs. 39%; adjusted odds ratio [aOR], 0.36 [95%

confidence interval {CI}, 0.24-0.53]), whereas patients positive for hepatitis B

surface antigen (HBsAg) were more likely to have spontaneously cleared HCV than

were those negative for HBsAg (43% vs. 21%; aOR, 2.91 [95% CI, 1.94-4.38]). Of

patients with HCV viremia, 786 (53%) carried HCV genotype 1, and 53 (4%), 440

(29%), and 217 (15%) carried HCV genotype 2, 3, and 4, respectively. A greater

HCV RNA level was associated with a greater chance of being infected with HCV

genotype 1 (aOR, 1.60 per 1 log higher [95% CI, 1.36-1.88]). Conclusions. @nbsp;

More than three-quarters of the HIV- and HCV Ab-positive patients in EuroSIDA

showed active HCV replication. Viremia was more frequent in IDUs and,

conversely, was less common in HBsAg-positive patients. Of the patients with HCV

viremia analyzed, 53% were found to carry HCV genotype 1, and this genotype was

associated with greater serum HCV RNA levels.

PMID: 18767985 [PubMed - as supplied by publisher]

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