HIV-1 and HCV co-infected patients: detection of active viral expression using a nested polymerase chain reaction

The aim of the present study was to determine, in a population of 70 HIV-1 infected patients with antibodies to HCV, the percentages of individuals with an active replication of HIV-1, HCV or both. During a one year follow-up of these patients at different stages of disease, blood samples were regularly collected for determination of transaminase, beta 2 microglobulin and CD4+ lymphocytes. Total RNAs were extracted from the sera, retrotranscribed with MoMuLV reverse transcriptase and nested PCR assays were carried out separately with sets of primers homologous to the 5' non-translated region of HCV and in HIV-1 gag. The amplified products were subjected to electrophoresis and observed under u.v. illumination after staining with ethidium bromide. For some samples, the identity of the amplified products was confirmed by Southern blotting by hybridization with enzyme-labelled probes. A total of 57% of the patients were found to produce HIV-1 RNA and 62% HCV RNA, while 34% produced both. HIV-1 RNA production was correlated with beta 2 microglobulin and CD4+ levels; active replication of HCV was correlated with hepatitis but not with CD4+ levels nor with HIV-1 RNA synthesis.