Hepatitis C virus infection and spontaneous clearance in HTLV-1 and HIV co-infected patients in Salvador, Bahia, Brazil

Abstract

Background While 20–40% of patients with hepatitis C virus (HCV) monoinfection will spontaneously clear the virus, less is known regarding clearance with coinfections. HCV, human immunodeficiency virus (HIV), and human T-cell lymphotrophic virus 1 and 2 (HTLV-1/2) coinfection occurs due to shared routes of transmission and is prevalent in Brazil. Objectives To compare the proportion of patients who have spontaneously cleared HCV in patients with HCV monoinfection to patients coinfected by HCV/HIV, or HCV/HIV/HTLV-1. Methods Using medical records from two clinics in Salvador, Brazil, including demographic data and serological markers of HCV, HIV and HTLV-I/II, cross-sectional data was obtained from 197 patients. Patients who were anti-HCV positive and HCV RNA negative, and who did not receive HCV treatment were defined as having cleared infection. Results Nineteen patients (9.5%) showed evidence of spontaneous HCV clearance; with clearance in 9 of 108 (8.3%) patients in the HCV monoinfected group, 5 of 68 (7.4%) patients with HCV/HIV, and 5 of 21 (23.8%) patients with HCV/HIV/HTLV. Demographic data were not associated with HCV clearance status. Patients coinfected with both HIV and HTLV-1 had increased odds (5.50; 95% CI 1.00, 30.17) of spontaneous clearance of HCV compared with patients who were HIV negative or of unknown HIV status. Conclusion Our study found that patients coinfected with HIV and HTLV-1 were more likely to spontaneously clear hepatitis C virus than patients with HIV/HCV or HCV alone. The effects of HTLV coinfection on the immune response of such patients may be associated with these findings.

Hepatitis C virus/human T lymphotropic virus 1/2 co-infection: Regional burden and virological outcomes in people who inject drugs

“…In contrast to the Japanese findings, however, two Brazilian studies [22,23] of HCV/HTLV-1 co-infection provide epidemiological and immunological evidence of a higher rate of spontaneous clearance of HCV in patients with HIV/HTLV-1 co-infection as compared to patients harbouring only an HIV/HCV co-infection or an HCV mono-infection. The differences between HCV and HTLV-1 interaction outcomes in these two settings may be due to host genetic factors (e.g., HLA genotypes), study design, or other unmeasured parameters of the study populations.…”

Interleukin-28B Polymorphism is a Pharmacogenetic Predictor during Sofosbuvir Plus Pegylated Interferon and Ribavirin Therapy for Chronic Hepatitis C Egyptian Patients

“…HCV infections spontaneously clear in approximately 15-45% of infected individuals [22,23]. Currently, there is a strong association between the rate of spontaneous clearance of HCV and IFN-λ polymorphisms [24].…”

Making the invisible visible: searching for human T-cell lymphotropic virus types 1 and 2 (HTLV-1 and HTLV-2) in Brazilian patients with viral hepatitis B and C

“…Changes in the immunological environment, particularly the balance between the Th2 immunological response induced by HCV and the Th1 response induced by HTLV-1, could be an explanation. Specifically, an increase in the spontaneous production of IL-1, IL-2, and IFN-g, reduction in the production of IL-4 by mononuclear cells, and elevated serum levels of pro-inflammatory cytokines might explain this finding ( Le Marchand et al 2015 , Silva et al 2016 , Espíndola et al 2017 ).…”

“…HCV/HTLV-1 co-infected patients harbour less severe hepatic injuries, as confirmed by lower levels of serum liver aminotransferases, other liver enzymes, and fibrosis, when compared with their HCV and HCV/HIV co-infected counterparts ( Cardoso et al 2009 , Bahia et al 2011 , Espíndola et al 2017 ). In addition, studies on HTLV-1 and HIV/HTLV-1 co-infected patients from Brazil found the spontaneous clearance of HCV and/or lower rate of HCV viremia detection ( Moreira et al 2013 , Le Marchand et al 2015 ). In contrast, a study in the USA described an increase in the HCV viral load among HIV and/or HTLV-2 co-infected individuals ( Hisada et al 2003 ).…”

“…In addition, although HCV/HTLV-1 co-infection has been associated with better outcomes among patients in Brazil ( Cardoso et al 2009 , Bahia et al 2011 , Moreira et al 2013 , Le Marchand et al. 2015 , Silva et al 2016 , Espíndola et al 2017 ), co-infection with HCV/HTLV-2 was described as having the opposite effect in a study from the USA ( Hisada et al 2003 ).…”