Abstract | BACKGROUND: Limited data exist describing the clinical outcome and immunological response primed during simultaneously acquired acute hepatitis C virus (HCV) and human immunodeficiency virus ( HIV) coinfection. We present detailed clinical and immunological analysis of 3 individuals after concomitant infection with acute HCV and primary HIV. METHODS: RESULTS: In all patients, anti-HCV treatment was started with pegylated interferon-alpha, and antiretroviral therapy was coadministered early during primary infection. HCV viremia was cleared under therapy with pegylated interferon-alpha in all 3 cases. In 2 patients, HIV replication was contained even after antiretroviral therapy had been interrupted, which was associated with strong HIV-specific CD8(+) and CD4(+) T cell responses. In these 2 patients, multispecific HCV CD4(+) T cell responses could also be detected. No HCV-specific CD4(+) T cell responses were detected in the third patient, who also had the lowest nadir CD4(+) cell count during primary HIV infection (<200 cells/microL). CONCLUSIONS: Anti-HIV and -HCV therapy should be considered early in cases of concomitant acute HCV and HIV coinfection, because successful therapy of HCV viremia seems possible even during primary HIV infection. HCV-specific T cell immunity is generated during primary HIV infection and can be preserved by HCV treatment. However, the optimal treatment algorithm needs to be established in prospective, randomized trials.
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Authors | Julian Schulze Zur Wiesch, Dorothea Pieper, Ingrid Stahmer, Thomas Eiermann, Peter Buggisch, Ansgar Lohse, Joachim Hauber, Jan van Lunzen |
Journal | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
(Clin Infect Dis)
Vol. 49
Issue 3
Pg. 466-72
(Aug 01 2009)
ISSN: 1537-6591 [Electronic] United States |
PMID | 19580412
(Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anti-HIV Agents
- Antiviral Agents
- Interferon alpha-2
- Interferon-alpha
- Recombinant Proteins
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Topics |
- Anti-HIV Agents
(therapeutic use)
- Antiretroviral Therapy, Highly Active
- Antiviral Agents
(therapeutic use)
- CD4 Lymphocyte Count
- CD4-Positive T-Lymphocytes
(immunology)
- CD8-Positive T-Lymphocytes
(immunology)
- Female
- HIV Infections
(complications, drug therapy)
- Hepatitis C
(complications, drug therapy)
- Humans
- Interferon alpha-2
- Interferon-alpha
(therapeutic use)
- Longitudinal Studies
- Male
- Middle Aged
- Recombinant Proteins
- Time Factors
- Treatment Outcome
- Viral Load
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