Detalle de: HCV RNA in peripheral blood cell subsets in HCV–HIV coinfected patients at the end of PegIFN/RBV treatment is associated with virologic relapse

Summary. Extrahepatic replication may have important implications for the treatment of hepatitis C virus (HCV). Our aim was to analyse the association between the presence of positive/negative strand HCV RNA in different peripheral blood cell subsets at the end of PegIFN/RBV treatment, and treatment response in HIV‐coinfected patients. Thirty‐four HCV–HIV coinfected patients who concluded 48 weeks of PegIFN/RBV treatment were included in the present study. Positive/negative strand HCV RNA was detected by amplification of the 5′ untranslated region (5′ UTR) using high‐temperature RT‐PCR in immunomagnetic‐isolated cell subsets. Twenty‐three patients (67.6%) had sustained virologic response (SVR) while 11 patients (32.4%) relapsed. The frequency of positive/negative strand HCV RNA in any cell subsets was significantly lower in patients with SVR (8.6%) compared to relapsers (63.6%) ( P = 0.002). Baseline HCV viral load was statistically higher among patients who relapsed ( P = 0.008), while patients with SVR had very early virologic response more frequently ( P = 0.003). Multivariate analysis showed, among these three variables, that only the presence of positive/negative strand HCV RNA was independently associated with relapse [ P = 0.024; OR 14 (14–137)]. In conclusion, the presence of positive/negative strand HCV RNA at the end of treatment is associated with relapse among HCV–HIV coinfected patients and might have important implications in the clinical practice.