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lymphocytes and viral replication
Jun 27, 2005

1)In the context of HIV/HepC co-infection, can T cells be lost without the HIV virus replicating? Or is it the replication itself that depletes the T cells? 2)If the HIV virus is replicating, is there always a detectable viral burden in serum, or a positive HIV qual PCR? thanks.

Response from Dr. McGovern

Most, but not all, T cell destruction is by HIV itself. In HIV/HCV patients some studies suggest that T cell responses to HIV medicines are not as good as in HIV patients without Hepatitis C. Some have wondered whether chronic hepatitis C may be a stimulator of T cells and lead to another pathway of cell death - one called apoptosis. However, there are other studies which DO NOT suggest that hepatitis C has a negative effect on T cell responses to HIV treatment whatsoever. So as you can see, we simply don't know the answer.

Since HIV is a chronic infection, HIV can always be found depending on how hard you look. Routine tests may not detect HIV RNA in blood. But research lab techniques can find HIV DNA in lymphocytes.

The important message is that taking HIV medications with excellent adherence keeps the virus suppressed and preserves T cells so that patients can do extremely well. That is clear.

Dr. McGovern



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