Short Communication HIV-coinfection leads to a modest increase in plasma HCV-RNA load in patients with chronic HCV infection Karin Neukam a , Silvia García-Rey a , Celia Cifuentes a , Juan Macías a , José A Mira a,b , María J Vázquez c , Manuel Parra-Sánchez a , José C Palomares a , Nicolás Merchante a , Federico A Di Lello a , Juan A Pineda a,⇑ a Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Avenida de Bellavista S/N, 41014 Seville, Spain b Internal Medicine Department, Hospital Universitario de Valme, Avenida de Bellavista S/N, 41014 Seville, Spain c Medical Services, Centro Penitenciario de Sevilla, Carretera Torreblanca-Mairena del Alcor, 41500 Alcalá de Guadaira, Spain article info Article history: Received 30 March 2012 Revised 21 June 2012 Accepted 21 June 2012 Available online 29 June 2012 Keywords: Hepatitis C virus HIV RNA load Pegylated interferon Ribavirin Polymerase chain reaction abstract The influence of HIV coinfection on plasma hepatitis C virus (HCV) RNA load has not been reliably eval- uated. We analyzed plasma HCV RNA load in 396 HCV-monoinfected and 467 HIV/HCV-coinfected patients. Median HCV RNA concentrations (interquartile range) in HCV-monoinfected patients were 5.88 (5.3–6.2) log 10 IU/mL versus 5.96 (5.6–6.5) log 10 IU/mL in HIV/HCV-coinfected individuals (p = 0.033) as determined with the Cobas Amplicor Test and 6.06 (5.4–5.7) log 10 IU/mL versus 6.3 (5.5– 6.9) log 10 IU/mL (p = 0.026) using the Cobas TaqMan System. The plasma HCV RNA load in patients with HIV infection and undetectable plasmatic HIV RNA was similar to that observed in HCV-monoinfected individuals [6.02 (5.45–6.61) log 10 IU/mL versus 6.01 (5.36–6.59) log 10 IU/mL, respectively (p = 1.0)]. In conclusion, HIV coinfection tends to be associated with higher plasma HCV RNA load, however, the mag- nitude of the differences is small and this effect can be counterbalanced with antiviral therapy. Ó 2012 Elsevier B.V. All rights reserved. 1. Introduction HIV coinfection considerably lowers the overall response rate to anti-hepatitis C therapy with pegylated interferon (Peg-IFN) plus ribavirin (RBV) (Carrat et al., 2004; Torriani et al., 2004). The underlying mechanism for this fact is not fully known. Differences in adherence, a poorer immune control of hepatitis C virus (HCV) replication and interactions with antiretroviral drugs have been pointed out as potential causes of this fact (Operalski and Kovacs, 2011). Plasma HCV RNA load has been identified as a strong predictor of sustained virologic response (SVR) to Peg-IFN plus RBV in HCV- monoinfected (Fried et al., 2002) and in HIV/HCV-coinfected (Carrat et al., 2004; Torriani et al., 2004; Pineda et al., 2010) pa- tients. It has been reported that HCV RNA levels are higher in HIV/HCV-coinfected patients than in HCV-monoinfected subjects (Gadalla et al., 2011; Di Martino et al., 2001; Sánchez-Quijano et al., 1995; Thomas et al., 2000), which may be due to a poorer im- mune control of HCV replication in the setting of HIV coinfection. This finding could partly explain the negative impact of HIV infection on anti-HCV treatment response. Nevertheless, this hypothesis is based on results obtained from studies that used pro- cedures for HCV RNA load quantification that were less sensitive than the current standard TaqMan PCR (Di Martino et al., 2001; Sánchez-Quijano et al., 1995; Thomas et al., 2000), that included low sample sizes (Di Martino et al., 2001; Sánchez-Quijano et al., 1995) and/or that were conducted in a specific subset of patients, which may not be representable of the overall HIV/HCV-coinfected population (Gadalla et al., 2011). In addition, the potential effect of the control of HIV replication by means of antiretroviral therapy (ART) was not always considered in these studies. Therefore, these observations might not be extrapolable to the present state of the art. Studies applying techniques according to the current standard, with higher sample sizes and adjusting results by the effects of controlled HIV replication are needed to elucidate this matter. This study was aimed to evaluate the influence of HIV coinfec- tion on plasma HCV RNA load in patients bearing HCV infection by using the Cobas Amplicor HCV Monitor test or the Cobas TaqMan system with two different detection limits (DL). 2. Patients and Methods This was a retrospective study which included all HCV-infected patients who were consecutively seen in the Infectious Diseases 0166-3542/$ - see front matter Ó 2012 Elsevier B.V. All rights reserved. http://dx.doi.org/10.1016/j.antiviral.2012.06.009 Abbreviations: DL, detection limit; HCV, hepatitis C virus; Peg-IFN, pegylated interferon; RBV, ribavirin; SVR, sustained virologic response. ⇑ Corresponding author. Address: Unidad de Enfermedades Infecciosas, Hospital Universitario de Valme, Avenida de Bellavista, 41014 Sevilla, Spain. E-mail address: japineda@telefonica.net (J.A Pineda). Antiviral Research 95 (2012) 212–215 Contents lists available at SciVerse ScienceDirect Antiviral Research journal homepage: www.elsevier.com/locate/antiviral