Evolution of coinfection with human immunodeficiency virus and hepatitis Cvirus in patients treated with highly active antiretroviral therapy

A retrospective analysis of data from a cohort of patients coinfected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) who were tre ated with highly active antiretroviral therapy (HAART) at 3 infectious dise ases units in northern Italy was performed. While the patients were receivi ng HAART, CD4(+) cell counts significantly increased and HIV RNA serum leve ls decreased. However, no significant overall changes in alanine aminotrans ferase (ALT) levels and HCV RNA serum levels were observed. Fifteen (4.6%) of 323 patients died within 3 years of follow-up; death was related to cirr hosis in 5 patients (1.6%). No significant difference was observed between cirrhosis-related mortality and mortality related to other causes. Patients with ALT levels >4 times the normal values at initiation of HAART showed a significant decrease in ALT levels, whereas patients with normal ALT level s at initiation of HAART showed a significant increase over time, suggestin g that HAART may have long-term beneficial or detrimental effects, dependin g on patient characteristics.