Increase in hepatitis C virus load in hemophiliacs during treatment with highly active antiretroviral therapy

The effect of highly active antiretroviral therapy (HAART) on liver functio n and viral load of hepatitis C virus (HCV) was studied in 21 hemophilic me n coinfected with HCV and human immunodeficiency virus (HIV). HCV RNA polym erase chain reaction was measured by branched DNA Quantiplex assay on froze n plasma samples obtained at baseline and at 24, 48, and 96 weeks after ini tiation of HAART, HCV RNA increased at 48 and 96 weeks after initiation of HAART therapy (198 x 10(5) Eq/mL [P =.03] and 227 x 10(5) Eq/mL [P <.0001], respectively, compared with baseline [141 x 105 Eq/mL]), This increase was associated with an increase in CD4 cell count and reduction in HIV viral l oad but no change in hepatic transaminases, With discontinuation of HAART, HCV RNA decreased as HIV RNA rebounded. Further study is required to clarif y the histopathologic significance of this finding.