Comparison of hepatitis C viral loads in patients with or without human immunodeficiency virus

A better understanding of how human immunodeficiency virus (HIV) coinfectio n affects the coarse of hepatitis C virus (HCV) infection is required to se lect patients with HIV who would benefit from current HCV therapy. Between June 1996 and March 2000, HCV RNA levels were quantified for 1,279 patients at the Louisiana State University Health Sciences Center; 28 of these pati ents were coinfected with HIV. HCV loads were quantified by the Bayer branc hed-DNA assay with a lower limit of detection of 0.2 Meg/ml. We compared th e median HCV RNA levels of for patients coinfected with HIV and HCV and pat ients infected only with HCV who were in the same age range (23 to 55 years ). The median HCV load for the 28 patients coinfected with HCV and HIV (17. 8 Meg/ml) was significantly greater (P < 0.05) than that for similarly aged patients infected only with HCV (6.1 Meg/ml). The HCV load did not correla te with age or sex for either group of patients. A significant (R = -0.4; P < 0.05) negative correlation was observed between HCV load and CD4 count i n the coinfected group, for whom the CD4 counts at the time of HCV load ana lysis ranged from 6 to 1,773/mm(3). The increased HCV load in patients coin fected with HCV and HIV compared to that in patients infected only with HCV and the inverse relationship of the HCV load to the CD4 count indicate tha t immunosuppression results in decreased control of HCV replication. In add ition, we report significantly higher HCV loads among coinfected African Am ericans than Caucasians.