Hepatitis C plasma viral load is associated with HCV genotype but not with HIV coinfection

Abstract

The influence of human immunodeficiency virus (HIV) coinfection and hepatitis C virus (HCV) genotype distribution on HCV viral load and alanine amino transferase (ALT) levels in chronically infected patients remains unclear. In the present study, serum samples from a group of haemophiliac patients were investigated retrospectively. HCV geno- and subtyping was carried out using the Inno line probe assay (Inno LIPA, Innogenetics, Zwijnaarde, Belgium) in 87 patients positive by HCV RT PCR. Of these patients, 31 (35.6%) were HIV coinfected. HCV RNA was quantified with the HCV Monitor kit (Roche, Basel, Switzerland) in 43 patients (22 HIV-negatives, 21 HIV-positives). The most prevalent genotypes were 1 (n = 52) and 3a (n = 16) followed by genotype 2 (n = 9) and 4 (n = 3). Mixed infections were detected in 7 patients. Of genotype 1 positive samples, 24 and 23 were classified as subtype a and b, respectively. Five samples could not be subtyped. Although higher mean values of ALT were observed in genotype 1 infected patients, there was no statistically significant association between HCV genotype or subtype and liver enzymes (P > 0.05). On the other hand, statistically significant higher HCV RNA titres were observed in haemophiliacs infected with HCV genotype 1 in comparison to those infected with other genotypes (P < 0.01). No relationship was found between the presence of HIV coinfection and viral load of HCV RNA. There was no evidence that HCV infection had a more severe outcome in HIV-positive patients who had been infected with HIV and HCV more than ten years ago, even in those with very low CD4+ cell counts. No clear association between high ALT levels and large amounts of viral RNA was observed. In conclusion, a large viral load is associated with HCV genotype 1 infection; HIV coinfection has no clear effect on the intensity of HCV replication. An ongoing prospective study will evaluate the respective role of viral load, genotype, HIV coinfection and ALT level in the response to interferon therapy.

Comparison of HCV viral load and its genotype distributions in HCV mono- and HIV/HCV co-infected illicit drug users

“…This study contradicts with Berger et al study [26] in which no correlation was seen between HIV infection and HCV viral load. The results of the current study revealed a strong correlation between HCV viral load and HIV co-infection as well as GT1 HCV genotype.…”

Predictors of Liver Fibrosis in HIV-Infected Patients with Chronic Hepatitis C Virus (HCV) Infection: Assessment Using Transient Elastometry and the Role of HCV Genotype 3

“…First, the risk of hepatotoxicity following initiation of antiretroviral drugs is greater in patients infected with HCV genotype 3 than in those infected with other genotypes [34][35][36][37]. Second, the use of some antiretrovirals could favor steatosis of the liver [27,[38][39][40][41]. In summary, HCV genotype 3 and antiretroviral therapy might be synergistic, together causing liver steatosis and indirectly accelerating the progression of liver fibrosis in HCV-HIV-coinfected patients.…”

Hepatitis C and HIV-1 coinfection

“…However, one report suggests that this may be the case only in patients infected with HCV genotype 1. 54 An association between serum HCV viral load and saliva HCV viral load has also been recently demonstrated, which may have major implications for HCV transmission in coinfected patients. 55 Together, these data demonstrate a higher rate of vertical and sexual transmission of HCV in coinfected patients, and that HIV is a cofactor for HCV transmission.…”