ART and HCV Activity

HIV infection is associated with accelerated progression of hepatitis C virus (HCV)-induced liver disease. Observational studies suggest that use of effective antiretroviral therapy (ART) may slow this progression. In HIV/HCV-coinfected patients, might HCV activity be attenuated by initiating ART before the CD4 count drops to <350 cells/mm³, the threshold at which many HIV-infected patients start treatment?

To answer this question, investigators in Spain studied the liver histology of HIV/HCV-coinfected patients who had liver biopsies performed when their CD4 counts were >350 cells/mm³. Although 78% of the 119 patients were receiving ART at the time of biopsy (median therapy duration, 206 weeks), only 40% had plasma HIV RNA levels <50 copies…