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Persons With HIV and Alcohol Problems Co-infected With Hepatitis C

Researchers at Boston Medical Center (BMC) and Boston University School of Public Health (BUSPH) have found that persons infected with the human immunodeficiency virus (HIV), who also have alcohol problems, were negatively affected by co-infection with the hepatitis C virus (HCV). These findings appear in the June issue of Alcoholism: Clinical Experimental Research.

Co-infection of HIV and HCV is a significant medical and public health concern due to its increasing prevalence and complex patient management. An estimated 15 to 30 percent of HIV infected persons in the United States and Europe are co-infected with HCV. According to previous research, alcohol use may worsen HCV-related liver disease and interfere with adherence to antiretroviral therapy (ART) and medical care.

The researchers studied 396 HIVinfected persons with alcohol problems. Fifty percent (199) were also co-infected with HCV. CD4 cell counts and HIV RNA levels were assessed at baseline and then again every six months for up to 42 months. Analyses of this data found a significant association between co-infection with HCV and lower CD4 cell counts among patients taking antiretroviral therapy.

"Determining whether HCV co-infection affects HIV disease progression is important for understanding the optimal timing and sequencing of therapies for these infections," said lead author Debbie Cheng, ScD, an associate professor in the department of Biostatistics at BUSPH.

According to senior author Jeffrey Samet, MD, professor of medicine at BUSM and chief of General Internal Medicine at Boston Medical Center (BMC), this study has important implications for understanding the optimal management approach for co-infected patients. "Our results suggest that HCV infection may adversely impact HIV-related immune reconstitution." "If this is true, additional improvement in HIV outcomes may be achieved by effective treatment of HCV infection in patients who a
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