Finally, a meta-analysis showed that patients with HIV-1/HCV coinfection had less immune reconstitution, as determined Regorafenib mw by CD4 cell count after 48 weeks of ART, than did patients with HCV infection alone [13]. Few studies have analysed the apoptosis of CD4 cells in this setting. One suggested that HCV coinfection sensitizes CD4 cells towards apoptosis in untreated HIV-1-positive patients, but that this effect is rapidly lost under effective ART [39]. Another study similarly found that apoptosis in naïve CD4 cells and in naïve and memory

CD8 cells was significantly higher in HIV-1/HCV-coinfected than in monoinfected patients who were not receiving ART [40]. In our series, we did not find any of the multiple HCV-related factors to be independently associated with CD4 cell count in ART-treated or untreated patients. Regarding virological responses, there is general agreement that HCV does not influence HIV-1 viral load in ART-treated patients [4–8,25,31–34]. Although a single study found a trend towards higher HIV-1 viral load in coinfected patients, significant differences were not observed [25]. This is not unexpected considering that ART has a dramatic effect on HIV-1 viral load that could not be compensated by any possible effect of

HCV. However, in one study, no significant association was found between HCV infection and HIV-1 RNA titre, regardless of ART status [8]. Similarly, another study reported that, following interruption of ART, plasma HIV-1 viral load did not differ between HIV-1-monoinfected and coinfected patients [34]. GSK-3 beta pathway Our series supports these findings, as we observed that neither active or past HCV infection nor any other HCV-related parameter influenced HIV-1 viral load in ART-treated or untreated patients. Regarding HCV genotypes, a study found that genotype 3, as opposed to genotype 1, was associated with HIV-1 disease progression in long-term nonprogressors [11]. However,

another study found that multiple combined genotypes accelerated clinical and immunological HIV-1 Florfenicol progression, and that genotype 1 was associated with faster immunological progression [41]. The latter study also found that the effect of HCV genotype on HIV-1 progression was greater in the pre-highly active ART era, suggesting to the authors that the effectiveness of ART may diminish the effect of HCV genotype on HIV-1 disease progression. However, we failed to confirm these results, as no significant effect of HCV genotype on immunological or virological outcomes was found either in the whole study group or in the subgroup of ART-untreated patients. Although many studies have analysed the possible effect of HCV on HIV-1 outcomes, there is a noteworthy lack of studies also analysing its effects on the liver, that is, hepatic fibrosis.