| The effect of highly active antiretroviral therapy (HAART) on plasma HCV RNA level in HIV-HCV co-infected individuals is uncertain. This issue was investigated over 12 months in HIV-HCV co-infected subjects HAART-treated for at least six months and achieving HIV RNA suppression below 500 copies/mL. It was predicted that HCV RNA would initially increase from baseline, decline thereafter, and fall below baseline by 12 months. Frozen plasma specimens were used to measure quantitative HCV RNA levels in 50 HAART-treated co-infected subjects at baseline, 3, 6, and 12 months. A 0.5 logo increase in HCV RNA at 3 months was observed. This was followed by a decline below baseline. As low HCV RNA is a predictor of virologic response to HCV therapy, it may be advantageous to first achieve suppression of plasma HIV RNA level, gain immune reconstitution with HAART, and then initiate HCV antiviral treatment in HIV-HCV co-infected individuals. |
