Change in transaminases in hepatitis C virus- and HIV-coinfected patients after highly active antiretroviral therapy: Differences between complete and partial virologic responders?

Patients with HIV and hepatitis C virus (HCV) coinfection have more severe hepatitis-related disease than do patients with HCV infection alone. Highly active antiretroviral therapy (HAART) with protease inhibitor appears to r estore pathogen-specific immune responses, especially in patients with pers istent undetectable HIV viral load. To evaluate the potent impact of immune restoration induced by HAART on the course of HCV-related disease, HCV vir emia and levels of transaminases were compared between two groups of patien ts: 10 HIV/HCV-coinfected patients with persistently undetectable HIV virem ia (group A) and 12 HIV/HCV-coinfected patients with persistent detectable HIV viremia. No difference was detected in HCV viral load in either group. An increase in transaminases was found only in patients with persistent und etectable HIV viral load, which was correlated with the increase in CD8(+) T cells. This may suggest that the restoration of CD8(+) T cell cytotoxicit y could lead to an enhancement of hepatitis C-related disease in HCV/HIV-co infected patients receiving HAART.