Hepatitis C Virus Coinfection And Hiv Load, Cd4(+) Cell Percentage, And Clinical Progression To Aids Or Death Among Hiv-Infected Women: Women And Infants Transmission Study

Background. Despite previous study, it remains unclear whether hepatitis C virus ( HCV) coinfection affects the progression of human immunodeficiency virus (HIV) type 1 infection. The Women and Infants Transmission Study provided an opportunity to assess this issue.Methods. Longitudinal data on 652 HIV-1-infected women enrolled in the study before the availability of highly active antiretroviral therapy ( HAART; 1989 - 1995) were analyzed. Random effects models were used to determine whether HCV coinfection was associated with different CD4(+) cell percentages and HIV-1 RNA levels over time, and Cox proportional hazards models were used to compare the rates of clinical progression to acquired immunodeficiency syndrome (AIDS) or death.Results. Of 652 women, 190 (29%) were HCV infected. During follow- up, 19% of women were exposed to HAART. After controlling for indicators of disease progression ( CD4(+) cell percentages and HIV-1 RNA levels determined closest to the time of delivery in pregnant women), ongoing drug use, receipt of antiretroviral therapy, and other important covariates, no differences were detected in the HIV-1 RNA levels, but the CD4+ cell percentages were slightly higher in HCV-infected women than in HCV- uninfected women. During follow- up, 48 women had progression to a first clinical AIDS- defining illness ( ADI), and 26 died with no documented antecedent ADI. In multivariable analyses, HCV- infected participants did not have faster progression to a first class C AIDS- defining event or death ( relative hazard, 0.75; 95% confidence interval, 0.37 - 1.53).Conclusions. In this cohort, the rate of clinical progression of HIV-1 infection was not greater for HCV-infected women.