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Background  Microglial cell activation and cerebral function impairment are described in both chronic hepatitis C viral (HCV) and Human-Immune-Deficiency viral (HIV) infections. The aim of this study was to investigate the effect of acute HCV infection upon cerebral function and microglial cell activation in HIV-infected individuals.    Methods  A case-control study was conducted. Subjects with acute HCV and chronic HIV coinfection ( aHCV ) were compared to matched controls with chronic HIV monoinfection  (HIVmono) .  aHCV  was defined as a new positive plasma HCV RNA within 12 months of a negative RNA test. Subjects underwent neuro-cognitive testing (NCT), cerebral proton magnetic resonance spectroscopy ( 1 H-MRS) and positron emission tomography (PET) using a  11 C-radiolabeled ligand (PK11195), which is highly specific for translocator protein 18 kDA receptors on activated microglial cells. Differences between cases and controls were assessed using linear regression modelling.    Results  Twenty-four  aHCV  cases completed NCT and  1 H-MRS, 8 underwent PET. Of 57  HIVmono  controls completing NCT, 12 underwent  1 H-MRS and 8 PET. Subjects with  aHCV  demonstrated on NCT, significantly poorer executive function (mean (SD) error rate 26.50(17.87) versus 19.09(8.12),  p  = 0.001) and on  1 H-MRS increased myo-inositol/creatine ratios (mI/Cr, a marker of cerebral inflammation) in the basal ganglia (ratio of 0.71(0.22) versus 0.55(0.23),  p  = 0.03), compared to subjects with  HIVmono . On PET imaging, no difference in  11 C-PK11195 binding potential (BP) was observed between study groups ( p >0.10 all cerebral locations), however lower BPs were associated with combination antiretroviral therapy (cART) use in the parietal ( p  = 0.01) and frontal ( p  = 0.03) cerebral locations.    Discussion  Poorer cognitive performance and disturbance of cerebral metabolites are observed in subjects with  aHC,V  compared to subjects with  HIVmono . Higher  11 C-PK11195 BP was not observed in subjects with  aHCV , but was observed in subjects not on cART.

Acute HCV/HIV Coinfection Is Associated with Cognitive Dysfunction and Cerebral Metabolite Disturbance, but Not Increased Microglial Cell Activation