Anti-HCV negative viral hepatitisC in HIV-infected patients from AIDS centre, Prague

Abstract number: P1110

Aster V., Konig J., Machala L., Rozsypal H., Shivairova O., Stankova M.

Objectives: Negative anti-HCV test is rare in common population. In contrast, in HIV infected persons with hepatitis C coinfection negative anti-HCV test is more frequent, especially in intravenous drug abusers. At the highest risk of seronegative HCV infection are HIV infected intravenous drug abusers with transaminase elevation or low CD4+ count. The aim of the study was to determine patients at the highest risk of seronegative HCV infection and to provide targeted HCV RNA testing using PCR method.

Methods: 666 HIV infected patients were followed-up at AIDS-Center Prague till August 2008. Data were collected through a retrospective search through the patients' clinical records. CD4+ count, transaminase value, and anti-HCV testing were done at up to a maximum 8 week interval. HCV RNA testing was started in HIV infected intravenous drug abusers with aminotransferase elevations or in those with CD4+ levels under 200/mcl.

Results: 49 (7.4%) of the 666 patients were intravenous drug abusers. In 14 of them transaminase elevation was observed; in 13, a CD4+ count of under 200/mcl was observed. 16 patients out of these 17 (14+13) were anti-HCV negative. To date to 7 of these anti-HCV negative patients HCV RNA test has been provided. 6 patients were HCV RNA positive and 1 patient HCV RNA negative.

Conclusion: Negative anti-HCV test in HIV/HCV coinfected patients, more so in intravenous drug abusers with transaminase elevations or with low CD4+ count, is more frequent than in patients with HCV infection alone. HCV RNA testing in HIV infected patients should be performed generally in anti-HCV positive patients, but also in selected anti-HCV negative patients. The study is funded by the grant Nr/9288–3 from the Internal Grant Agency of the Ministry of Health of the Czech Republic.