Carmo Ricardo A, Guimarães Mark D C, Moura Alexandre S, Neiva Augusto M, Versiani Juliana B, Lima Letícia V, Freitas Lílian P, Rocha Manoel Otávio C
Hemominas Foundation, Belo Horizonte, Brazil.
Braz J Infect Dis. 2008 Jun;12(3):173-9. doi: 10.1590/s1413-86702008000300003.
The potential impact of the hepatitis C virus (HCV) on clinical, immunological and virological responses to initial highly active antiretroviral therapy (HAART) of patients infected with human immunodeficiency virus (HIV) is important to evaluate due to the high prevalence of HIV-HCV coinfection. A historical cohort study was conducted among 824 HIV-infected patients starting HAART at a public referral service in Belo Horizonte, Brazil, to assess the impact of HCV seropositivity on appearance of a new AIDS-defining opportunistic illness, AIDS-related death, suppression of viral load, and an increase in CD4-cell count. A total of 76 patients (9.2%) had a positive HCV test, 26 of whom (34.2%) had a history of intravenous drug use. In multivariate analysis, HCV seropositivity was associated with a smaller CD4-cell recovery (RH=0.68; 95% CI [0.49-0.92], but not with progression to a new AIDS-defining opportunistic illness or to AIDS-related death (RH=1.08; 95% CI [0.66-1.77]), nor to suppression of HIV-1 viral load (RH=0.81; 95% CI [0.56-1.17]) after starting HAART. These results indicate that although associated with a blunted CD4-cell recovery, HCV coinfection did not affect the morbidity or mortality related to AIDS or the virological response to initial HAART.
由于人类免疫缺陷病毒（HIV）与丙型肝炎病毒（HCV）合并感染率很高，因此评估HCV对HIV感染患者初始高效抗逆转录病毒治疗（HAART）的临床、免疫和病毒学反应的潜在影响非常重要。在巴西贝洛奥里藏特的一家公共转诊服务机构，对824例开始接受HAART治疗的HIV感染患者进行了一项历史性队列研究，以评估HCV血清学阳性对出现新的艾滋病界定机会性疾病、艾滋病相关死亡、病毒载量抑制以及CD4细胞计数增加的影响。共有76例患者（9.2%）HCV检测呈阳性，其中26例（34.2%）有静脉吸毒史。多变量分析显示，HCV血清学阳性与CD4细胞恢复较小有关（相对危险度=0.68；95%可信区间[0.49-0.92]），但与进展为新的艾滋病界定机会性疾病或艾滋病相关死亡无关（相对危险度=1.08；95%可信区间[0.66-1.77]），开始HAART治疗后也与HIV-1病毒载量抑制无关（相对危险度=0.81；95%可信区间[0.56-1.17]）。这些结果表明，虽然HCV合并感染与CD4细胞恢复减弱有关，但并未影响与艾滋病相关的发病率或死亡率，也未影响对初始HAART的病毒学反应。
