What is the impact of HIV on the immune response to acute hepatitis C virus?
In HIV coinfection, the rate of spontaneous clearance is significantly lower than that in HCV monoinfection, with reported rates ranging from 5 to 24% [82-84]. Furthermore, the viral set point is increased in HIV infection with one large cohort demonstrating an HCV load more than 1 log higher than that of HCV monoinfected individuals [83]. In chronic HCV infection, HIV-positive men are more likely to shed HCV RNA in semen than their HIV-negative counterparts [85]. Interestingly, the humoral response to HCV appears to be delayed in HIV infection. In a London cohort of 43 HIV-positive individuals with acute HCV, the proportion who had a negative HCV antibody results was 37, 10 and 5% at 3, 9 and 12 months after their first HCV RNA positive test result, respectively [86]. As a result, some have suggested that HCV-RNA testing should be performed for screening high-risk populations. The poor control of HCV is the result of HIV’s impact on the cell-mediated immune responses. It is clear that
