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High Rate of Hepatitis C Infection Clearance in HIV-1 Natural Viral Suppressors
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Reported by Jules Levin
CROI 2010 Feb 16-19 SF
N Shakeri, R Redfield, and Mohammad Sajadi*
Inst of Human Virology, Univ of Maryland Sch of Med, Baltimore, US
ABSTRACT
Background: Approximately 1% of the HIV-1 infected population can control HIV-1 replication to undetectable levels in the absence of antiretroviral therapy. We have recently described such a cohort of HIV-1 infected individuals, Natural Viral Suppressors (NVS). In this study we decided to see if the NVS were also successful at controlling another chronic viral infection, Hepatitis C.
Methods: A cross-sectional study was undertaken to examine Hepatitis C-related parameters in the following cohorts: NVS, HIV and Hepatitis C co-infected, and Hepatitis C. The NVS are HIV-infected individuals with HIV-1 viral loads <400 copies/mL, who are enrolled into the NVS study. The HIV/Hepatitis co-infected group was all individuals with a serologic diagnosis of HIV-1 and a diagnosis of Hepatitis C. The Hepatitis C cohort was HIV-negative individuals with a diagnosis of Hepatitis C infection. HIV-1 infection was defined as having a serologic diagnosis of HIV-1, while lack of infection was defined as having a negative HIV ELISA. Hepatitis C infection was defined as having a positive PCR. As the NVS cohort is all African-American, the other cohorts were race-matched. Clearance of Hepatitis C was defined as having a positive antibody, but a negative PCR. Statistical analysis was performed with Graph Pad Prism (San Francisco, CA) for the unpaired t test and Fischer's exact test.
Results: Twenty-nine of the 45 persons in the NVS cohort (64%) had a positive Hepatitis C antibody and were included in this study. In addition, 350 HIV/Hepatitis C individuals and 350 Hepatitis C patients were included in this study. The 3 cohorts were similar in terms of race, age, mode of acquisition, and Hepatitis C genotypes. The NVS demonstrated a 24.1 % (7 of 29) clearance rate for Hepatitis C, while the HIV/Hepatitis C cohort had a 6.6% (23 of 350) clearance rate, and the Hepatitis C had a 8.0% (28 of 350) clearance rate. The higher rates of Hepatitis C clearance in the NVS were statistically significant when compared to the HIV/Hepatitis C (P =0.004) and Hepatitis C cohorts (P =0.011). There was no statistical difference between the Hepatitis C viral loads between the NVS and the other 2 cohorts.
Conclusions: NVS patients, who have been infected with Hepatitis C virus, have higher rates of Hepatitis C clearance that dual HIV/Hepatitis C infected or Hepatitis C mono-infected patients. Patients who are able to suppress HIV and Hepatitis C virus infections likely share a similar mechanism that exerts an effect on both viruses.
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