Researchers from Stanford University and the Veterans Affairs Palo Alto Health Care System in Palo Alto, Calif., warn that HIV antiretroviral treatment can worsen long-term hepatitis C infection and lead to drug-resistant strains of HCV, Drug Week reports. The investigators followed three groups of HIV and HCV coinfected patients--treatment-naive patients who began anti-HIV drugs at the beginning of the study, patients not taking any anti-HIV medications, and those who had already been on antiretroviral regimens before the study.
The researchers found that the group that had been on anti-HIV therapy before the start of the study had higher and significantly more diverse HCV viral loads. They also had higher T-cell counts, which, while helping to control HIV replication, also appeared to be linked with a worsening of HCV infection. "These results suggest that there is no immediate effect of [highly active antiretroviral therapy] on HCV, but that with prolonged HAART, immune restoration results in an increase in HCV load and quasi-species diversity," the researchers concluded. The full report, titled "Impact of Highly Active Antiretroviral Therapy and Immunologic Status on Hepatitis C Virus Quasi-Species Diversity in Human Immunodeficiency Virus/Hepatitis C Virus-Coinfected Patients," can be seen in the Journal of Virology.