A Study On HIV/HCV Co-infection

Objectives: To investigate the rate of co-infection with HCV among HIV infected person, abnormality of serum aminotransferase level in HIV/HCV co-infected person, the influence of co-infection with HCV on CD4 positive T cell counts and HIV viral load and prognosis of HIV infected patients, the influence of co-infection with HIV on the prognosis of HCV infected patients.Methods: High-risk people of HIV infection were investigated from 1998 to 2003,their serum samples were collected, Antibodies against HIV (anti-HIV) and Antibodies against HCV (anti-HCV) were detected by ELISA, CD4+T cells were detected by flow cytometer (FCM), HCV RNA level and HIV viral load were tested by quantify PCR. Some patients were re-visited many years after HIV or HCV infection.Results: 476 were HIV infected among 923 individuals investigated (232 males, 244 females, ages range from 0.5 to 68 years, the mean age is 35.4 years). 85.9% of 476 HIV positive patients were co-infected with HCV. 92.5% of blood-transmitting HIV positive patients (372/402), 30.8% of sexual-transmitting HIV positive patients (4/13) and 28.6% of vertical-transmitting HIV positive children (10/35) had HCV infection.ALT level was examined among 47 HCV infected subjects before anti-HCV and anti-HIV therapy. There was no significant difference of the rate of ALT abnormality was observed between HCV+HIV+ subjects and HCV+HIV- subjects.The mortality of 409 HCV/HIV co-infected subjects and 179 simple HCV infected subjects were reviewed ten years after infection, there was a significant difference between these two groups (P<0.05). Five cases of HCV/HIV co-infected subjects had final-stage liver disease compare to none of simple HCV infected subjects.ALT level was also examined among 39 HIV positive subjects who had notreceived anti-HIV therapy and 47 HIV positive subjects who had undertaken anti-HIV therapy, the rate of ALT abnormality of HIV+ HCV+ subjects were obviously higher than which of HIV+HCV" subjects(ddI,d4T,EFV).In our study, the rate of ALT abnormality of HIV positive patients had not changed obviously after receiving anti-HIV therapy.CD4+ T cells were detected among 82 HIV infected person who had not received anti-HIV therapy and 83 HIV infected person who had received anti-HIV therapy for six months, no significant difference of the CD4+ T cell counts has been observed between HIV/HCV co-infected subjects and single HIV infected subjects, but single HIV infected subjects had a more increase in CD4* T cell counts after anti-HIV therapy than HIV/HCV co-infected subjects(P< 0.05).HIV viral load were tested among 25 HIV/HCV co-infected patients and 20 simple HIV infected patients who had received anti-HIV therapy for six months, there was no significant difference of HIV viral load between two groups.We have also tried but failed to observe the correlation between HCV RNA level and HIV viral load among HIV/HCV co-infected person.The mortality of 409 HIV/HCV co-infected subjects and 68 simple HIV infected subjects were reviewed, there was a significant difference between these two groups (P < 0.05).Conclusion:Co-infection with HCV is common among HIV infected person transmitting by the blood exposure. The rate of HIV Co-infection with HCV by the blood exposure are higher than which by sexual way and vertical transmission.Co-infection with HCV is one of the important causes of abnormality of serum aminotransminase level in HIV infected patients.The rates of final-stage liver disease and the mortality of patients Co-infected with HIV and HCV are higher than which of patients with simple HIV or simple HCV infection.Usually.treating HIV/AIDS patients with ddI d4T and EFV for six months haveno harm to lever function.Correlation between HCV RNA level and HIV viral load was not observed among HIV/HCV co-infected person.Co-infection with HCV may slower the immune restoration of HIV infected patients.