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HCV TREATMENT RESPONSE IN HIV/HCV CO-INFECTED PATIENTS: RELATIONSHIP TO BASELINE CD4 COUNT
JD Farley, TM Maung, TA Farley
In those co-infected with HIV/HCV, there is a relatively lower likelihood of achieving the primary goal of treating HCV (mono-infected): attaining a sustained virologic response (SVR). A number of small studies indicate that baseline CD4 count is related to treatment response to HCV therapy. There is, however, little Canadian data from community (non-academic treatment) settings on this.
AIM: To determine the relationship between baseline CD4 count and treatment response to HCV therapy in HIV/HCV co-infected patients treated in community clinic setting.
Patients and METHODS: We did a retrospective analysis on 38 cases ( co-infected individuals completing HCV treatment with Pegylated (PEG) and RBV and with pre-treatment CD4 values). The median pre-HCV treatment baseline CD4 count was 385/mm3 and HIV viral load and HCV RNA levels were 11,400/mm3 and 1,268,510 IU/ml respectively. Mean age was 40.1 years. There were 34 males and four females.
RESULTS: Overall, the mean baseline CD4 count for those who attained SVR was 495/mm3 (14 cases), 409/mm3 (21 cases) for those who had reached EOT and 384/mm3 (11 cases) for non-responders. For those with genotype 1,those who attained SVR had the highest pre-treatment baseline CD4 counts: 638/mm3, (EOT-489/mm3, Non-responders-421/mm3).
CONCLUSION: Although the numbers treated are relatively small, our experience indicate that the outcome is related to pre-HCV treatment CD4 levels; the higher the baseline value, the better is treatment response to HCV. In addition to genotype, baseline CD4 value is another factor to be considered when counseling HCV/HIV co-infected individuals for HCV therapy.