HCVRNA increase during antiretroviral treatment (ART) induced HIVRNA rapid phase decline: An evidence of virus-virus interaction?

Abstract

Background: Liver damage has been described in HIV+ patients with HCV coinfeetion undergoing combination ART. Aims and Methods. In order to assess the relationship between CD4, CD8,HIVRNA, HCVRNA (both measured by bDNA) and liver enzymes during combination antiretroviral treatment (ART), we measured these parameters in 12 HIVHCV coinfected patients on the day before, 3, 7, 14, 28, 56 and 84 days after starting: d4T and 3TC in all, Indinavir in 6 and Nevirapine in 6. Results: HIVRNA declined rapidly and significantly. CD4 raised slowly. CD8 cells and liver enzymes were stable. HCVRNA show a significant increase (7.55 +/at day 14 7.61 +/-at day 21 vs. 7.35 +/at baseline M+/SE log copies/mi p<0.05) independent from Indinavir use. Increase of HCVRNA levels was observed in 10/12 patients all showing a 2 log decrease of HIVRNA and was not related to liver damage. An ALT increase greater than 100% was observed in 4/12 patients all showing HCVRNA increase. Conclusions: The relationship between HCVRNA increase and decline of HIVRNA suggests interference between the two viruses. HCVRNA increase may elicit liver damage only in a minority of patients. Viral hepatitis: basic aspects