PLoS ONE (Jan 2022)

Risk of HIV viral rebound in HIV infected patients on direct acting antivirals (DAAs) treatment for HCV.

  • Giulia Morsica,
  • Laura Galli,
  • Emanuela Messina,
  • Antonella Castagna,
  • Sabrina Bagaglio,
  • Stefania Salpietro,
  • Della Torre Liviana,
  • Caterina Uberti-Foppa,
  • Hamid Hasson

DOI
https://doi.org/10.1371/journal.pone.0262917
Journal volume & issue
Vol. 17, no. 2
p. e0262917

Abstract

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BackgroundThe dynamic of HIV-viral load (VL) remains poorly investigated in HIV/HCV patients under direct acting antivirals (DAAs).MethodsWe retrospectively evaluated HIV-VL at baseline (BL) during and up to 24 weeks post-DAAs in a cohort of 305 HIV-1/HCV patients, on ART and with no HIV virological failure (VF) in the 6 months before treatment with DAAs; during the period of observation VF was defined as confirmed VL≥50 copies/mL; virological blips (VB, transient, not confirmed, VL ≥50 copies/mL). Stepwise Cox regression models were fitted to estimate adjusted hazard ratios (aHR) of VF.ResultsFifteen VF occurred in 13 patients over 187 person-years of follow-up (PYFU): incidence rate (IR) of 8.0 per 100-PYFU (95% CI = 4.0-12.1); 29 VBs were detected in 26 patients over 184 PYFU: IR = 15.8 per 100-PYFU (95% CI = 10.0-21.5). The most prominent factor associated with VF was the presence of BL HIV residual viremia (RV = HIV-RNA detectable but not precisely quantifiable) [aHR = 12.26 (95% CI = 3.74-40.17), PConclusionsOur findings underline the importance for close monitoring HIV-VL in selected patients. Whether this phenomenon is triggered by the rapid clearance of HCV remains to be established.