Clinicoimmunological Progression and Response to Treatment of Long-Term Nonprogressor HIV–Hepatitis C Virus-Coinfected Patients

Abstract

We assess the severity and response to treatment of hepatitis C virus (HCV) infection in a cohort of long-term nonprogressors (LTNP) and analyze whether HCV infection affects the progression of HIV-1 infection. A case-control study comparing coinfected LTNP (n = 28) with coinfected normal progressors (NP) (n = 56) was performed. Signs of hepatopathy, response to HCV treatment, HIV viral load (VL), and lymphocyte T subsets were analyzed. A cohort of LTNP with (n = 28) and without HCV infection (n = 7) was compared to assess the influence of HCV on HIV-1 infection. Liver enzymes were lower in LTNP than in NP. There were no significant differences between LTNP and NP in clinical signs of chronic liver disease at physical examination, echostructure, degree of inflammation, or fibrosis score in liver biopsy. There were no differences in the response to HCV treatment between groups (57% vs. 45%, p = 0.69). LTNP presented a proportionally higher drop of CD4 during HCV treatment, which persisted 2 years after discontinuing treatment [-195, -10, and 30 cells/mm3 HCV-treated LTNP (n = 7), NP (n = 56), and non-HCV-treated LTNP (n = 21), respectively, p < 0.05]. There were no differences in any variables analyzed when coinfected and monoinfected LTNP were compared. LTNP do not seem to have a better outcome or response to HCV treatment than NP. HCV-treated LTNP could have a worse HIV progression than HIV-HCV-treated NP or untreated coinfected LTNP. HCV infection does not have a deleterious effect on the progression of LTNP.