predictors of chronic hepatitis c evolution in hiv co-infected patients from romania

background due to a recent alarming increase in the number of hiv-hcv co-infected patients in romania. objectives a cross sectional study was conducted to assess the baseline predictors of liver disease evolution. patients and methods 83 hiv-hcv co-infected patients, untreated for hcv infection, were evaluated for viral replication, liver fibrosis (estimated by a noninvasive marker - fib4), and plasma levels of ip-10 (interferon-gamma inducible protein 10) - a cytokine associated with an unfavorable outcome of hcv infection. results the median value for hcv viral load was high (6.3 log10 iu/ml), 98.8% of the patients were infected with hcv genotype 1. although 53% of the patients received antiretroviral therapy (cart), only 31.8% of these achieved undetectable hiv levels. hcv viral load was significantly higher in patients with aids (6.4 vs. 6.1 log10iu/ml; p = 0.04), and in those naïve for cart (6.5 vs. 5.9 log10 iu/ml; p = 0.04). severe fibrosis was directly correlated with immunosupression (56% vs. 17.4%, p = 0.03), hcv replication (6.1 vs. 4.9 log10iu/ml p = 0.008), and ip-10 median values (312 vs. 139 pg/ml, p=0.008). a serum ip-10 level higher than 400 pg/ml was significantly associated with fib-4 median values (4.09 vs. 1.7, p = 0.004), hcv viral load (6.4 vs. 6.1 log10 iu/ml, p = 0.02) and alt level (206.8 vs. 112.4 iu/l, p = 0.05). conclusions an important part of the hiv-hcv co-infected patients had negative baseline predictors for the evolution of hcv infection; their therapeutical management must be conducted with special attention towards adherence and potential overlapping drug toxicities. high concentrations of plasma ip-10 are reliable markers for the severity of liver disease.