Parisi SG, et al. - Authors performed this longitudinal study to describe cellular HIV-DNA changes and their correlation with HIV low-level plasma viremia (LLV) in HIV–HCV co-infected patients on successful antiretroviral and anti-HCV therapy by treatment with direct-acting antivirals (DAA). In this study, HIV–HCV co-infected patients experienced a multifaceted perturbation of cellular HIV-DNA levels within a 24-week period during anti-HCV treatment; the extent of the phenomenon was greater in subjects with UV. Fast HCV-RNA clearance seemed to influence cellular reservoir more than the plasma HIV-RNA.

Methods

• Authors examined thirty-nine patients prior to the start of DAA (T0), after week 12 (T1) and 24 weeks (T2) of anti-HCV therapy.
• They performed analysis of cellular PBMC HIV-DNA as an absolute value and as the percentage of increase or decrease from T0 to T2.
• They classified patients as having undetectable plasma HIV viraemia (UV) or LLV in the year before the start of anti-HCV treatment and within the T0–T2 study period.

Results

• 35/39 patients (89.7%) indicated the same plasma HIV viraemia control in the year before HCV treatment and in the T0–T2 interval.
• Higher HIV-DNA value at T0 and at T2 was observed in patients with LLV than in subjects with UV (p = 0.015 and p = 0.014, respectively).
• Authors observed that a similar proportion of patients with LLV and UV experienced an increase or decrease of HIV-DNA from T0 to T2.  
• In this study, the percentage increase in HIV-DNA value (262.8%) from T0 to T2 was higher compared to the decrease (43.5%) in patients with UV (p = 0.012), and it was higher compared to the percentage increase in HIV-DNA value reported in subjects with LLV (262.8 versus 49%, p = 0.026).