638-M. Immune Recovery during Antiretroviral Therapy in Patients Infected with HIV-1 and Hepatitis C Virus Co-Infection: A Cohort Study

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Session 84 Poster Session
HCV Co-Infection and HIV/HCV Immune Responses
Session Time: 4:30-6:30 pm
Room 4E-F

638-M.

Immune Recovery during Antiretroviral Therapy in Patients Infected with HIV-1 and Hepatitis C Virus Co-Infection: A Cohort Study
S. Moreno*, A. Moreno, F. Dronda, M. J. Perez-Elias, C. Quereda, J. L. Casado, A. Antela, and M. E. Moreno
Hosp. Ramón y Cajal, Madrid, Spain

Background: There is controversy with regard to the impact that co-infection with HCV may have on the immune recovery during antiretroviral therapy for HIV-infection.
Methods:This was an observational, prospective cohort single-center study of all naïve HIV-infected patients who started HAART after March 1996, and who maintained complete viral suppression for at least 24 months. The CD4-cell recovery was analysed according to HCV serostatus.
Results: Among 503 patients who initiated therapy in this period, 286 (58%) had undetectable viral load for at least 24 months; 185 (65%) patients were co-infected with HCV+. Baseline characteristics of patients who were HCV+ and HCV- were similar except for the percentage of patients that were intravenous drug user in each group (90% of HCV+ and 9% in HCV-, p<0.001). At baseline median CD4 count was 213 and 265 cells/mm³ for HCV+ and HCV- patients, respectively (p=0.25), and median viral load was 4.88 and 5.07 log copies/mL, respectively. The number of patients that were receiving protease inhibitors was also similar in the 2 groups (91% and 92%, respectively). There were no significant differences in the median increase in CD4 count at 12 months between the groups (220 for HCV+ and 194 for HCV-), but the differences became significant at month 18 (301 vs 233, p=0.01) and was sustained through month 24 (325 vs 272, p=0.03). After 24 months of controlled viremia, CD4 count reached 591 cells/mm³ in HCV+ patients and 476 cells/mm³ in HCV- patients.
Conclusions: Co-infection with HCV impairs CD4 cell recovery in HIV-infected patients receiving potent antiretroviral therapy. These findings should be taken into account for decisions regarding treatment of HCV in HIV co-infected patients.