HCV coinfection may have role in changes in body composition in HIV patients

Among some HIV-positive individuals receiving antiretroviral therapy, chronic coinfection with the hepatitis C virus (HCV) appears to be related to changes in insulin resistance, plasma lipid profile and body fat composition, according to a report by French researchers.

In a cross-sectional study, Dr. Michel Duong, from Hopital du Bocage, Dijon, and colleagues studied 29 such patients. All had sustained alanine aminotransferase levels at least twice the normal value, according to the team’s report in the July 1st issue of the Journal of Acquired Immune Deficiency Syndromes.

In addition, the researchers studied two control groups: 76 HIV-positive individuals receiving antiretroviral therapy who did not have HCV infection, and 123 untreated HCV-positive patients who did not have HIV infection. Lipoatrophy was more frequent among HIV-HCV patients compared with the two control groups, they found.

The insulin resistance level was similar between coinfected patients and HCV-positive control patients, and it was significantly higher in these two groups than in the HIV-positive control patients. The risk of developing insulin resistance significantly correlated with HCV infection (odds ratio 8.8, p = 0.003).

Dr. Duong’s team also found significantly lower levels of total cholesterol (p = 0.01), LDL cholesterol (p = 0.009) and triglycerides (p = 0.02) among HIV-HCV-positive patients compared with HIV-positive patients. They determined that body mass index, triglyceride level, total cholesterol and peripheral fat wasting were some of the variables independently related to HCV infection.

The authors suggest that although “viral coinfections have never been considered as potentially confounding factors in studies dealing with the role of antiretroviral drugs in the development of metabolic and body fat disturbances,” the role that HCV infection plays in these processes needs to be clarified.