Studies advance knowledge of HIV impact on hepatitis C infection and genes that may thwart HCV

Infectious disease experts at Johns Hopkins have found that among people infected with the hepatitis C virus (HCV), co-infection with HIV, speeds damage and scarring of liver tissue by almost a decade.

In a second study of HCV infection, the Johns Hopkins research team participated in the discovery of two that make it more likely that patients' immune systems can rid the body of HCV. Both studies are described in articles published online in February ahead of print in the journal .

"Our latest study results suggest that HIV might promote aging and disease progression in people with HCV," says infectious disease specialist and senior investigator, David L. Thomas, M.D., M.P.H. Thomas, who is the Stanhope Bayne-Jones Professor and director of infectious diseases at the Johns Hopkins University School of Medicine and a professor at the university's Bloomberg School of , says that among 1,176 study participants, those co-infected with HCV and HIV showed the same severity of and cirrhosis as those who were infected only with HCV but were 9.2 years older. All study participants were current and former intravenous drug users from Baltimore whose health and disease progression were being monitored with bi-monthly check-ups and samples taken from 2006 to 2011.

The United States estimates that a quarter of the 3.2 million Americans chronically infected with HCV are also infected with HIV.

"There has been a growing hypothesis that HIV may accelerate the aging process, resulting in an earlier onset of chronic disease, including cancer, cardiovascular and . Until now, there have not been strong data to support this theory," says study lead investigator and infectious disease epidemiologist Gregory Kirk, M.D., Ph.D., M.P.H.

"There has been concern that increased chronic diseases in people aging with HIV may simply reflect their greater exposure to alcohol, tobacco or illicit drugs," adds Kirk, an associate professor at the Johns Hopkins Bloomberg School of Public Health. "Importantly, this investigation showed an increased severity of liver disease among people with HIV compared to people without HIV but whose pattern of smoking, alcohol drinking and illicit drug use was very similar."

"Co-infected patients may have to be monitored more closely for worsening liver disease, and may require earlier and more aggressive treatment than people without HIV infection," adds study co-investigator and epidemiologist Shruti Mehta, Ph.D., M.P.H. Although the reason for the accelerated rate of liver disease with HIV is unclear, the study results suggest that HIV and aging may share common mechanisms of immune activation that speed up HCV disease progression, says Mehta, an associate professor at the Bloomberg School of Public Health. Mehta and Kirk are both co-principal investigators of the long-term monitoring of the Baltimore group, known as the ALIVE cohort, which is short for the AIDS Linked to the IntraVenous Experience study.

The second study is believed to be the largest genetic investigation ever conducted of people infected with HCV. In it, researchers at 13 medical centers in five countries, including Thomas' Johns Hopkins team, analyzed nearly 800,000 differences in the genetic code among 919 people whose immune systems showed antibody evidence of having successfully fought off HCV infection, and another 1,482 people who became infected with the disease.

Lead study investigator and genetic epidemiologist Priya Duggal, Ph.D., M.P.H., says 40 percent of people exposed to HCV, predominantly of white and Asian ancestry, "spontaneously fight off infection" without any need for drug therapy, suggesting a genetic basis to risk of infection.

The international team's analysis showed that 15 percent of study participants who failed to become infected with HCV had either or both of two genetic variants, one near the gene for interleukin-28B and the other near the genes for HLA class II. Duggal, an assistant professor at the Bloomberg School of Public Health, says this information may help explain "with a relatively high degree of genetic certainty" why racial differences exist among those who do become infected. However, she cautions that further research is needed to determine the full impact of these genetic variants on preventing and treating HCV in people of different ethnicities.

Thomas says the findings may help physicians predict the people who are most likely to self-recover from exposure to HCV, and those who will most likely require aggressive treatment right away.

HCV infection is the nation's leading cause of liver failure, liver cancer and liver transplantation. The disease, transmitted by contact with blood and other bodily fluids of an infected person, and through sexual activity, injection drug use or sharing of personal care items, kills more than 10,000 Americans annually. An estimated 185 million people worldwide are infected with HCV.

More information: The latest study went online Feb. 26, the other was Feb. 18.

add to favorites email to friend print save as pdf

Related Stories

HIV-HCV coinfection speeds HCV-related liver fibrosis

Feb 27, 2013

(HealthDay)—Individuals who are coinfected with HIV and hepatitis C virus (HCV) exhibit liver fibrosis similar to that of individuals without HIV who are nearly 10 years older, according to research published ...

Recommended for you

Recorded Ebola deaths top 7,000

4 hours ago

The worst Ebola outbreak on record has now killed more than 7,000 people, with many of the latest deaths reported in Sierra Leone, the World Health Organization said as United Nations Secretary-General Ban ...

Liberia holds Senate vote amid Ebola fears (Update)

9 hours ago

Health workers manned polling stations across Liberia on Saturday as voters cast their ballots in a twice-delayed Senate election that has been criticized for its potential to spread the deadly Ebola disease.

Evidence-based recs issued for systemic care in psoriasis

Dec 19, 2014

(HealthDay)—For appropriately selected patients with psoriasis, combining biologics with other systemic treatments, including phototherapy, oral medications, or other biologic, may result in greater efficacy ...

Bacteria in caramel apples kills at least four in US

Dec 19, 2014

A listeria outbreak believed to originate from commercially packaged caramel apples has killed at least four people in the United States and sickened 28 people since November, officials said Friday.

Steroid-based treatment may answer needs of pediatric EoE patients

Dec 19, 2014

A new formulation of oral budesonide suspension, a steroid-based treatment, is safe and effective in treating pediatric patients with eosinophilic esophagitis (EoE), according to a new study in Clinical Gastroenterology and Hepatology, the official clinical practice journal ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.