Effects of active HCV replication on neurologic status in HIV RNA virally suppressed patients

Neurology. 2009 Jul 28;73(4):309-14. doi: 10.1212/WNL.0b013e3181af7a10.


Background: Hepatitis C virus (HCV) is a frequent copathogen with HIV. Both viruses appear to replicate in the brain and both are implicated in neurocognitive and peripheral neuropathy syndromes. Interaction of the viruses is likely to be complicated and better understanding of the contributions of each virus will be necessary to make evidence-based therapeutic decisions.

Methods: This study was designed to determine if active HCV infection, identified by quantitative HCV RNA determination, is associated with increased neurocognitive deficits or excess development of distal sensory peripheral neuropathy in HIV coinfected patients with stable HIV viral suppression. The AIDS Clinical Trials Group Longitudinal Linked Randomized Trials (ALLRT) study was the source of subjects with known HIV treatment status, neurocognitive and neuropathy evaluations, and HCV status. Subjects were selected based on HCV antibody status (249 positive; 310 negative).

Results: HCV RNA viral loads were detectable in 172 participants with controlled HIV infection and available neurologic evaluations in the ALLRT. These participants were compared with 345 participants with undetectable HCV viral load and the same inclusion criteria from the same cohort. Neurocognitive performance measured by Trail-Making A or B and digit symbol testing was not dissimilar between the 2 groups. In addition, there was no significant association between active HCV replication and distal sensory neuropathy.

Conclusion: Clinically significant neurocognitive dysfunction and peripheral neuropathy were not exacerbated by active hepatitis C virus infection in the setting of optimally treated HIV infection.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Acquired Immunodeficiency Syndrome / complications
  • Acquired Immunodeficiency Syndrome / drug therapy
  • Acquired Immunodeficiency Syndrome / virology
  • Adult
  • Causality
  • Cognition Disorders / diagnosis
  • Cognition Disorders / immunology
  • Cognition Disorders / virology*
  • Cohort Studies
  • Female
  • HIV Infections / diagnosis
  • HIV Infections / drug therapy
  • HIV Infections / virology*
  • Hepacivirus / genetics
  • Hepatitis C / complications*
  • Hepatitis C / immunology
  • Humans
  • Immunocompetence / drug effects
  • Immunocompetence / immunology
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Peripheral Nervous System Diseases / diagnosis
  • Peripheral Nervous System Diseases / immunology
  • Peripheral Nervous System Diseases / virology*
  • Prospective Studies
  • RNA, Viral / analysis
  • RNA, Viral / metabolism
  • Viral Load
  • Virus Replication / genetics


  • RNA, Viral