Determinants of immunological and virological responses to antiretroviral therapy amongst HIV-infected adults in central Argentina: negative influence of hepatitis C infection

• Published in: Transactions of the Royal Society of Tropical Medicine and Hygiene Vol. 107; no. 7; pp. 432 - 437
• Main Authors: Farías, Adrián Alejandro, Kremer, Luís Emilio, Allende, Luís, Díaz, María del Pilar, Pisano, María Belen, Contigiani, Marta Silvia, Ré, Viviana Elizabeth
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.07.2013
• Subjects: Adult; Aged; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiretroviral Therapy, Highly Active; Antiviral agents; Argentina - epidemiology; Biological and medical sciences; CD4 Lymphocyte Count; CD4-Positive T-Lymphocytes - immunology; Coinfection - epidemiology; Coinfection - immunology; Coinfection - virology; Female; General aspects; Hepatitis C - epidemiology; Hepatitis C - immunology; Hepatitis C - virology; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Infections - immunology; HIV Infections - virology; Human viral diseases; Humans; Infectious diseases; Logistic Models; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Prevalence; Retrospective Studies; Risk Factors; Seroepidemiologic Studies; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral Load; Young Adult; South America; Argentina; America; HIV/HCV coinfection; viral load; response to therapy; CD4 cell counts; HAART; Antiretroviral agent; Hepatic disease; Microbiological investigation; Immunological investigation; T-Lymphocyte; Adult; Antiviral; Tropical medicine; Viral load; Viral hepatitis C; Human; Immunopathology; AIDS; Immune deficiency; Infection; Virus; Numeration; Chemotherapy; Treatment; Viral disease; Digestive diseases; Flaviviridae; Hepatitis C virus; Hepacivirus
• ISSN: 0035-9203; 1878-3503
• DOI: 10.1093/trstmh/trt043

Background The purpose of this study was to update the epidemiological data on the prevalence of coinfection with hepatitis C virus (HCV) and HIV, and to identify whether specific clinical and epidemiological factors influenced the response of HIV-positive adults to highly active antiretroviral therapy (HAART). Methods This retrospective observational cohort study of 238 HIV-infected patients evaluated the effect of different epidemiological and clinical parameters (including HCV coinfection) on therapy response among HIV-infected adults initiating HAART. Multiple logistic regression models were used to identify factors associated with therapy response and estimated risk coefficients. Results Seroprevalence of HCV infection in this population was 26% (62/238). We did not observe a significant association between immunological or virological response relating to patient gender or HAART regimen. However, this analysis showed that HCV serological status, age at HIV diagnosis, duration of treatment and WHO clinical stage of AIDS (<200 CD4 cells/ml independently of viral load either < or > to100 000 copies/ml), were significantly associated with immunological and virological responses to HAART. Conclusions These results show further evidence that hepatitis C serostatus is associated with a reduced response to HAART.