HCV Co-Infection Compromising the Effects of c-ART?An Insight from the HIV-Positive Population in Bulgaria

Hepatitis C is common in HIV-positive patients and may considerably impact their prognosis. In Bulgaria, 26 % of the HIV+ patients diagnosed between 2010 and 2014 were HCV seropositive, with a very high rate of active co-infections, and multi-risk profile. Immunological and virological parameters (CD4AC, CD4/CD8, HIV viral load) at the time of HIV diagnosis were similar as compared to HIV monoinfection but deteriorated quickly until registration at hospital. Only 52 % of HIV+ patients with active HCV infection were started on c-ART. In the absence of HCV-specific therapy, they were characterised by significantly inferior immune restoration (in terms of CD4 AC and CD4/CD8 increase), and lower rate of sustained HIV virologic response (63 % vs.38 %, pless than0.0001). Altogether, HCV co-infection is a significant risk factor for the progress of HIV epidemics in Bulgaria, and requires specific efforts for successful management and treatment of a multi-risk patients group.