Hepatitis C infection in HIV-1 natural viral suppressors

HIV-1 natural viral suppressors (NVSs) demonstrate an intrinsic ability to control HIV-1 replication in the absence of antiretroviral therapy. The objective of this study was to investigate whether HIV-infected NVSs also demonstrate enhanced ability to control hepatitis C virus (HCV) infection, and whether HCV infection in the NVSs affects the degree of HIV control.

A cross-sectional study was undertaken to compare HCV-related parameters in the NVS to the two race-matched cohorts (HIV/HCV-coinfected or HCV-monoinfected patients). Within the NVS, HIV-related parameters were compared based on the presence or absence of chronic HCV.

NVS patients had a significantly higher clearance rate of HCV at 23.3% (seven of 30), compared to the 6.5% (23 of 350) of HIV/HCV-coinfected and 9.1% (32 of 350) of HCV-monoinfected patients (P = 0.005 and P = 0.024, respectively). Apart from the HCV clearance rate, there was no significant difference in HCV-related parameters such as HCV viral load or liver histology in the NVS with chronic HCV compared to HCV/HIV-coinfected patients or HCV-monoinfected patients. However, NVS patients with chronic HCV infection had statistically significant lower CD4 cell count and CD4%, and lower CD4/CD8 ratio compared to those NVSs without chronic HCV infection (P = 0.029, P = 0.046, and P = 0.062, respectively).

It appears that some NVS patients have the ability to effectively control multiple agents that can cause chronic viral infections. In addition, it appears that the presence of chronic HCV infection within the NVS adversely affects immunological parameters.