Human immunodeficiency virus (HIV) is a virus that attacks the immune system. Hepatitis C, on the other hand, is an infection caused by a virus (HCV) that damages the liver. What do they both have in common?
In Spain, it is estimated that 30% of the total number of HIV-positive people – between 130,000 and 160,000 – are co-infected with HCV. A fact which could be explained by the fact that the two viruses share common transmission routes; In the past, HCV co-infection was common among people diagnosed with HIV, particularly among injection drug users.
According to Doctor José Miguel Benito, researcher at the Jiménez Díaz Foundation Health Research Institute (IIS-FSJ/UAM) at the Rey Juan Carlos University Hospital, “in Spain, the most frequent route of transmission at the beginning of the epidemic – decade of the 80s and 90s of the last century – was administered parenterally among intravenous drug users, which meant that a high percentage of people infected with HIV were also infected with HCV.
In this context, and because of concerns about the impact that HCV infection may have on the clinical course of HIV, research is essential to determine whether a doubly stressed immune system may worsen the health of HIV-positive people. in the long term. For Doctor Norma Rallón, one of the leaders of the study and also a researcher at the IIS-FJD/UAM of the Rey Juan Carlos University Hospital, “research around the theme of co-infection with HIV and HCV is very important not only because not only the health problem, given the high prevalence of HCV infection in the HIV population, but also because of the great challenge for the immune system of people infected with both virus and all the consequences that this leads.
The research team in Infectious Diseases and Tropical Medicine from IIS-FJD/UAM and the Fundación Jiménez Díaz and Rey Juan Carlos University Hospitals (Móstoles), which carried out the study, are working on it. The AAD Era: Assessing Patients. Characteristics, clinical impact and emergence of comorbidities in people co-infected with HIV/HCV compared to people infected with HIV, which has just been published in Journal of Clinical Medicineto determine whether curing HCV infection can modify the clinical course of people co-infected with HIV and HCV.
The problem of HIV/HCV co-infection
In general, co-infection with HIV and HCV complicates both diseases: the presence of both viruses in the same person generates interactions, so that one infection can modify the clinical course of the other. In the study, researchers analyze the impact of recovery from HCV infection in people living with HIV, particularly on the incidence of morbidity and mortality in the population infected with both viruses .
As highlighted by Dr. Beatriz Álvarez, first signatory of the study, specialist in the Department of Infectious Diseases of the Jiménez Díaz Foundation and researcher at the Health Research Institute of the Jiménez Díaz Foundation (IIS-FJD/UAM) , “people living with HIV suffer from a higher incidence of different pathologies and at earlier ages of life than the HIV-negative population due to the existence of inflammation chronic. If we add to this the hepatitis C virus, “this fact is aggravated” because we are talking about another virus that causes chronic infection.
The power of new direct-acting antivirals
Advances in drugs to treat the hepatitis C virus have made leaps and bounds over the past decade. One of these advances came from new direct-acting antivirals (DAAs), which have succeeded in revolutionizing the care of people infected with the hepatitis C virus, a growing infection that each time presents new cases and the causes of which we know. we must look “in the consumption of intravenous drugs and in sexual transmission, especially when we combine the two ingredients, as happens with the phenomenon of chemsex —drug use for sexual purposes—and slamsex intravenously,” explains Dr. Álvarez.
Thanks to these antivirals, it is possible to act directly on the replication of the virus, which makes it possible to achieve, in just two or three months, a cure rate close to 100%, fewer side effects and excellent tolerance. . “This advance has completely changed the scenario of hepatitis C, transforming it into a disease that is widely expected to be eradicable,” admits Dr. Álvarez. “Until the development of this type of medication, there were only medications to treat HCV that were ineffective, toxic and poorly tolerated, with which, to have a 50% chance of cure, it was necessary to complete a year of side effects and toxicity “for the body”, underlines the expert.
But now, researchers, after studying a total of 229 people co-infected with HIV and HCV, as well as a control group of HIV-positive people of similar size and characteristics, were able to conclude that successful elimination of HCV thanks to DAAs considerably improves the outlook. regarding comorbidities and survival of individuals co-infected with HIV/HCV, matching the prognosis of these patients to that of the comparison group, hence the importance of intensifying efforts for early detection of HCV infection. early implementation of curative treatment, accompanied by the promotion of healthy lifestyle habits. “This approach will not only influence the prevention of liver damage in particular, but will contribute, more generally, to improving the general health status and life expectancy of those affected,” explains Dr. Álvarez.
Finally, Dr. Rallón highlights the importance of the multidisciplinary and cooperative work of the research team, made up of staff from the Fundación Jiménez Díaz and Rey Juan Carlos University Hospitals, under the aegis of IIS-FJD/UAM. “We form a multidisciplinary team made up of clinical and fundamental researchers, which is essential for any translational research whose ultimate goal is to improve the quality of life of patients,” he adds, also thanking the support of research organizations. funding, other research centers. with whom they collaborate and, mainly, volunteers and patients participating in the studies.
