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Treatment of Co-Infection Despite Very Low CD4+ Cell Counts

By Sean R. Hosein

October 25, 2010

In general, treatment guidelines for HCV-HIV co-infection encourage the initiation of HCV therapy at counts well above the 200 CD4+ cell level. The reason for this is that HCV therapy can temporarily reduce CD4+ cell counts, and if these fall too low there is a risk that life-threatening infections could develop.

Researchers in Barcelona and elsewhere in Spain conducted a pilot study to evaluate the safety of HCV therapy in co-infected people with low CD4+ cell counts. Their results are surprising and may incite the initiation of larger studies to explore the issue of HCV therapy in people with low CD4+ cell counts.

Study Details

Researchers recruited 11 co-infected volunteers, all who had HCV genotype 1 and who were taking anti-HIV therapy. None had hepatitis A or B or any other significant health condition. They were divided into two groups as follows:

All participants received standard treatment for HCV -- interferon and ribavirin adjusted according to body weight.


Preliminary results of 12 weeks of therapy were made available:

Since no serious AIDS-related infections occurred and significant reductions in HCV viral load were seen, at least over the short-term, the Spanish researchers say that larger and longer studies are warranted in co-infected people with low CD4+ cell counts.


  1. von Wichmann MA, Crespo M, Rodriguez-Arrondo F, et al. Pilot study to evaluate safety and HCV kinetics in HCV/HIV co-infected patients with less than 200 CD4+, treated with peginterferon alfa-2b and ribavirin (P04675 study). In: Program and abstracts of the 18th International Conference on AIDS, 18-23 July 2010, Vienna, Austria. Abstract MOPE0178.

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