Influence of Hepatitis C virus coinfection on immune reconstitution in HIV subjects

• Published in: Medical microbiology and immunology Vol. 208; no. 6; pp. 747 - 756
• Main Authors: Badano, María Noel, Parodi, Cecilia, Aloisi, Natalia, Corti, Marcelo, Elizalde de Bracco, María Marta, Baré, Patricia
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-12-2019; Springer Nature B.V
• Subjects: Activation; Adolescent; Adult; Aged; Anti-Retroviral Agents - therapeutic use; Antiretroviral agents; Antiretroviral drugs; Antiretroviral therapy; Biomedical and Life Sciences; Biomedicine; CD4 antigen; CD4 Lymphocyte Count; CD4-CD8 Ratio; CD8 antigen; Coinfection - immunology; Cross-Sectional Studies; Cytokines - blood; Hepatitis; Hepatitis C; Hepatitis C - complications; HIV; HIV - isolation & purification; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - immunology; Human immunodeficiency virus; Humans; Immune Reconstitution; Immune response; Immunology; Liver; Liver diseases; Longitudinal Studies; Lymphocytes T; Male; Medical Microbiology; Middle Aged; Original Investigation; Patients; Viral Load; Virology; Viruses; Young Adult; Immunological reconstitution; HIV/HCV coinfection; Immune activation; Liver disease; Antiretroviral treatment
• ISSN: 0300-8584; 1432-1831
• DOI: 10.1007/s00430-019-00619-4

Despite successful HIV suppression by antiretroviral treatment (ART), immune activation may persist in HIV patients, contributing to an impaired immunological reconstitution and disease progression. Information regarding Hepatitis C virus (HCV) coinfection as a factor that accounts for immune activation in HIV subjects remains unclear. Furthermore, most studies have been carried out considering HIV/HCV patients as a whole, without taking into account the presence or absence of liver damage. Therefore, it is unknown if HCV and/or its liver-related disease could act as two independent factors contributing to the immune activation. In this study, we investigated the presence of immune activation in a cohort of 50 HIV/HCV patients by measuring cytokine levels, CD4
+
T-cell counts and CD4/CD8 ratios. Six patient groups were defined according to HIV viral load, HCV status, and liver disease to assess the impact of each of these factors on immune activation and reconstitution in HIV/HCV patients. Only subjects with controlled HIV infection and cleared HCV displayed immunological parameters within normal ranges. The mere presence of HCV contributes to immune activation leading to an inappropriate immunological reconstitution. This state exacerbates in the presence of HCV-associated liver disease. Our results suggest that ART is not enough to suppress immune activation in the context of HIV/HCV coinfection, since both HCV and its liver-related disease would contribute to the immune activation. Given that immune activation worsens immunological reconstitution and clinical status, these results support the priority of HCV treatment in HIV/HCV patients and suggest the monitoring of their liver status.