Purpose of the studyHCV is one of the most relevant co‐morbidities seen in HIV‐infected individuals as evidenced by the negative impact that HIV exerts on the course of HCV infection. Despite remarkable results on HIV infection alone, the impact of highly active antiretroviral therapy (HAART) on liver disease in co‐infection remains unknown. We sought to explore the impact of raltegravir (RAL) on amino transferase (ALT) in HIV/HCV co‐infected individuals.MethodsHIV‐infected individuals co‐infected with HCV within the last 5 years receiving non‐integrase inhibitor containing HAART with a subsequent switch to RAL‐containing HAART were identified from a retrospectively maintained outpatient database. Patient demographics were extracted. Biochemical, virological and immunological parameters were collated and individuals received pegylated interferon with ribavirin were excluded. ALT levels at switch and post switch were compared using Kruskal‐Wallis test. Spearman's Rank correlation was used to assess the relationship between ALT and HCV‐RNA.Summary of resultsTwenty‐seven HIV‐HCV co‐infected individuals were identified between January 2007 and January 2012 and seven individuals were excluded. Median age was 44 years (range: 31–68). Five had acute and fifteen had chronic HCV infection during the switch. Twenty (100%) had HIV‐RNA‐1<40 copies/mL at time of RAL switch. In chronic HCV infected individuals, median ALT levels at the time of switch were 465 IU/L, decreased significantly to 179 IU/L 1 month following switch (p=0.0261) and to 140 IU/L 6 months later (p=0.0225). On the other hand, in acute HCV infected individuals median ALT levels were 1005 IU/L at time of switch but decreased significantly to 220 IU/L 1 month later (p=0.0034) and to 35 IU/L 6 month later (p=0.0026). Sustained improvement in ALT levels from baseline to 1 month and up to 24 weeks after switch to RAL was observed in both groups but the reduction in ALT levels was statistically more significant in acutely infected individuals. ALT and HCV‐RNA levels showed a positive correlation at 6 months pre, post and at time of switch both in acute and chronic HCV‐infected individuals (Spearman's Rank correlation).ConclusionIn our study, RAL had a favourable effect on the liver up to 24 weeks after switch in HIV/HCV infected individuals.image