Hepatitis C virus and HIV type 1 co-infection

Priyanka Gupta

doi:10.4081/idr.2013.s1.e7

Abstract

Around 33 million people worldwide are living with Human Immunodeficiency Virus (HIV) infection, and approximately 20-30% of HIV-infected individuals are also infected with Hepatitis C virus (HCV). The main form of HCV transmission is via the blood borne route; high rates of co-infection are found in intravenous drug users with HCV prevalence rates as high as 90%. Introduction of effective antiretroviral therapy (ART) has led to a significant decline in HIV-related morbidity, but at the same time the incidence of HCV related liver disease is increasing in the co-infected population. Meta analysis has revealed that individuals who are co-infected with HIV/HCV harbor three times greater risk of progression to liver disease than those infected with HCV alone. Increased risk of progression to Acquired Immunodeficiency Syndrome (AIDS) and AIDS-related deaths is shown among the co-infected patients by some studies, suggesting that HCV infection may accelerate the clinical course of HIV infection. HCV may also affect the incidence of liver toxicity associated with ART, affecting the management of HIV infection. There is a lack of optimal therapeutic approaches to treat HCV infection in HIV co-infected patients. This review discusses recent literature pertaining HIV/HCV co-infection, in addition to providing a snapshot of impact of co-infection on human genome at the level of gene expression and its regulation by microRNAs (miRNAs).

Highlights

Acknowledgements: this review is a part of PhD dissertation of Priyanka Gupta who is a recipient of Australian Postgraduate Award by the have sex with men (MSM), and have no per- University of Sydney
Introduction of effective antiretroviral therapy (ART) has led to a signifin cant decline in human immunodeficiency virus (HIV)-related morbidity, but at o the same time the incidence of Hepatitis C virus (HCV) related liver disease is increasing in the co-infected e population
Meta analysis has revealed that s individuals who are co-infected with HIV/HCV u harbor three times greater risk of progression l to liver disease than those infected with HCV

Summary

HCV is spread less efficiently by sexual

Sydney, Australia transmission than HIV.[6,7,8,9] In hemophiliacs coinfected with HIV and HCV, HIV infection was detected in 13% and HCV in only 3% of 162. Studies suggested that there was no association between HIV-HCV co-infection and poor disease outcome These studies suggested that the co-infected patients had higher rate of liver-related mortality, there was no increased risk of AIDS and mortality rates as compared to HIV monoinfected individuals.[14,15] Kaufmann et al demonstrated that HCV seropositive patients had smaller increase in CD4+ T lymphocytes than HCV seronegative patients. No difference in the increase of CD4+ T count during ART in HCV infected individuals as compared to HCV un-infected individuals.[27]

Before initiation of antiretroviral therapy

Number of patients

No difference in global gene expression between

Findings

The effect of antiretroviral therapy on liver