Hepatitis C and Progression of HIV Disease

CONTEXT Conflicting reports exist regarding the effect of hepatitis C virus (HCV) on the progression of human immunodeficiency virus (HIV) disease. OBJECTIVE To assess the effect of HCV infection on clinical and immunologic progression of HIV disease and immunologic response to highly active antiretroviral therapy (HAART). DESIGN Prospective cohort study. SETTING University-based, urban HIV clinic in the United States. PATIENTS There were 1955 patients enrolled between January 1995 and January 2001 who were eligible for analysis because of having at least 1 return visit to the clinic and being free of acquired immunodeficiency syndrome (AIDS) at enrollment. Median (interquartile range) length of follow-up was 2.19 (1.00-3.50) years for HCV-infected and 2.00 (1.00-3.00) years for HCV-uninfected patients. MAIN OUTCOME MEASURES Progression to an AIDS-defining illness, survival, and progression to a CD4 cell count below 200/µL; CD4 cell count change following initiation of effective HAART (resulting in a viral load of