Changes in HIV RNA and CD4 Cell Count After Acute HCV Infection in Chronically HIV-Infected Individuals

L. Gras, F. de Wolf, C. Smit, M. Prins, J.T.M. van der Meer, J.W. Vanhommerig, A.H. Zwinderman, J. Schinkel, the ATHENA study group, the MOSAIC study, S. Lowe, A. Oude Lashof, D. Posthouwer, R.B. Geskus

Research output: Contribution to journalArticleAcademicpeer-review


Little is known about the impact of acute hepatitis C virus (HCV) co-infection on HIV-1 disease progression. We investigated CD4 cell count and HIV RNA concentration changes after HCV infection in individuals chronically infected with HIV-1.We selected individuals that had the last negative and first positive HCV RNA test less than 1 year apart. Bivariate linear mixed-effects regression was used to model trends in HIV RNA level and CD4 cell count from 2 years before the last negative HCV RNA test until the first of the following dates: start of anti-HCV medication, change in combination antiretroviral therapy (cART) status, and end of follow-up.At the estimated time of HCV co-infection, of 89 individuals, 63 (71%) were cART-treated and 26 (29%) were not on cART. In persons on cART, median CD4 cell count declined from 587 to 508 cells per cubic millimeter (P <0.0001) during the first 5 months after HCV infection and returned to 587 cells per cubic millimeter after 2.2 years. Also, the probability of an HIV RNA >50 copies per milliliter peaked to 18.6% at HCV co-infection, with lower probabilities 6 months before (3.5%, P = 0.006 compared with peak probability) and after (2.9%, P = 0.009). In persons not on cART, no significant impact of HCV co-infection on trends in the HIV RNA level or CD4 cell count was observed.Acute HCV infection in cART-treated, chronically HIV-infected patients was associated with a temporary decrease in CD4 cell counts and increased risk of HIV viremia >50 copies per milliliter. This may increase the risk of further HIV transmission.
Original languageEnglish
Pages (from-to)536-542
JournalJaids-journal of Acquired Immune Deficiency Syndromes
Issue number5
Publication statusPublished - 1 Jan 2015

Cite this