HIV-positive people with hepatitis C virus (HCV) experienced progression to liver fibrosis if their HIV viral load rebounded above 1000 copies/mL or remained detectable on 2 consecutive tests, researchers reported in the January edition of HIV Medicine. Smaller transient HIV "blips," however, were not associated with worsening fibrosis. Optimized antiretroviral therapy, the study authors suggested, may protect the liver.
HIV/HCV coinfected people are known to experience more rapid liver fibrosis progression than people with hepatitis C alone, though the reason for this is not fully understood. SMART and other studies have shown that interruption of antiretroviral therapy (ART) and lack of HIV viral suppression are associated with liver, heart, and kidney disease, but it is not known what level of viremia affects liver fibrosis progression.
Curtis Cooper and fellow investigators with the Canadian Co-infection Cohort Study looked at the relationship between HIV viral load and fibrosis progression in 288 HIV/HCV coinfected people in the cohort. A majority (74%) were men, the mean age was 45 years, and the median CD4 T-cell count was 440 cells/mm3. Most (81%) reported a history of injection drug use and half currently drank alcohol.
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