Hepatitis C viral load in HCV-monoinfected and HCV/HIV-1-, HCV/HTLV-1/-2-, and HCV/HIV/HTLV-1/-2-co-infected patients from São Paulo, Brazil

Abstract

Co-infections of hepatitis C virus (HCV) and either human immunodeficiency virus type 1 (HIV-1), human T-cell lymphotropic virus type 1 (HTLV-1) or type 2 (HTLV-2) have been described as having an impact on HCV viremia and subsequent disease progression. HCV load in serum samples from 622 patients (343 males, 279 females; median age 50.8 years) from São Paulo/southeast Brazil was analyzed using the Abbott Real Time HCV assay (Abbott Molecular Inc., IL, USA). Samples were obtained from HCV-monoinfected (n=548), HCV/HIV-1- (n=41), HCV/HTLV-1- (n=16), HCV/HTLV-2- (n=8), HCV/HIV/HTLV-1- (n=4), and HCV/HIV/HTLV-2-co-infected (n=5) patients, and results were compared among the groups and according to sex. The median HCV load in HCV-monoinfected patients was 5.23 log IU/mL and 0.31 log higher in men than in women. Increases in viral load of 0.51 log, 0.54 log, and 1.43 log IU/mL were detected in HCV/HIV-1-, HCV/HTLV-1- and HCV/HIV/HTLV-1-co-infected individuals, respectively, compared with HCV-monoinfected counterparts. In contrast, compared to HCV/HIV co-infected patients, HCV/HTLV-2-co-infected patients had an HCV load of 5.0 log IU/mL, whereas HCV/HIV/HTLV-2-co-infected patients had a median load 0.37 log IU/mL lower. Significant differences in HCV loads were detected, with males and HCV/HIV-1- and HCV/HIV/HTLV-1-co-infected patients presenting the highest values. Conversely, females and HCV/HTLV-2-co-infected patients exhibited lower HCV loads. Overall, HCV viremia is increased in HIV and/or HTLV-1-co-infection and decreased in HTLV-2 co-infection.

Line Immunoassay for Confirmation and Discrimination of Human T-Cell Lymphotropic Virus Infections in Inconclusive Western Blot Serum Samples from Brazil

“…The LIA confirmed the presence of HTLV-2 in 11/21 (52.4%) of the WB-indeterminate samples. The high number of HTLV-2-positive samples in G2 leads us to suppose that these patients acquired HBV and HCV, as well HTLV-1/2 and HIV, at the same time, probably by the parenteral route and prior to the time when serological testing for HIV and HBV (1989), and subsequently for HTLV and HCV (1993), became mandatory in blood banks throughout Brazil; in addition, intravenous drug addiction was more frequent in this country, as previously described (18)(19)(20). Corroborating this hypothesis, older age and male sex predominated in G2.…”

“…The serum samples employed in the present study were obtained from the biorepositories of the HTLV Research Laboratory (LPHTLV), Department of Immunology, Adolfo Lutz Institute (IAL), located in São Paulo, Brazil, and the Integrated and Multidisciplinary HTLV Center (CHTLV), located at the Bahiana School of Medicine and Public Health (EBMSP) in Salvador, Bahia, Brazil. Briefly, the samples from São Paulo were collected between 2012 and 2016 in the course of previous studies designed to detect the prevalence of HTLV-1/2 in HIV-infected individuals as well as in patients with hepatitis B virus (HBV) or hepatitis C virus (HCV) infection in the state of São Paulo, Brazil (14,15,(18)(19)(20). The samples from Salvador, Bahia, were obtained by routine diagnostic procedures at an outpatient clinic in Salvador (CHTLV) from 2015 to 2017; these samples were additionally used to assess the performances of four commercially available HTLV serological screening tests in Brazil (21).…”

Evaluation of the Inflammatory Cytokines and IL-10 Network in Individuals Co-infected With Human T-Cell Lymphotropic Virus and Hepatitis C Virus (HTLV/HCV)

“…Moreover, more HCV-infected patients were non-responders to the treatment, with high inflammatory liver activity and advanced liver fibrosis. In Brazil, some studies have suggested that HTLV co-infection may have a positive effect on spontaneous HCV clearance (Alves et al, 2018), which occurs equally in patients triple infected with HTLV, HCV, and HIV-1 (Bahia et al, 2011;Moreira et al, 2013;Le Marchand et al, 2015). However, a study conducted in Japan reported that HTLV decreased the response to the treatment with IFN-α and reduced the clearance of HCV (Kishihara et al, 2001).…”

Surveillance of human retroviruses in blood samples from patients with hepatitis B and C in São Paulo, Brazil

“…In HCV/HTLV-1-coinfected individuals from Japan, higher HCV viremia, a lower rate of sustained virologic response to α-interferon treatment, and an increased risk of chronic liver disease and hepatocellular carcinoma have been described [7][8][9] . In São Paulo, Brazil, increased HCV viremia was observed in patients with hepatitis C when coinfected with HIV and/or HTLV-1 10 . However, in Salvador, Bahia, patients coinfected with HIV and HTLV-1 were more likely to spontaneously clear the HCV than patients with HIV/HCV or HCV alone 11 .…”

“…However, in Salvador, Bahia, patients coinfected with HIV and HTLV-1 were more likely to spontaneously clear the HCV than patients with HIV/HCV or HCV alone 11 . Conversely, coinfection with HTLV-2 has been shown to slow the progression to AIDS in HIV-infected individuals 12 and to decrease HCV viral loads in people with hepatitis C 10,13 . Thus, the search for HTLV-1 and HTLV-2 in HIV-infected individuals, as well as in patients with HBV and HCV, has prognostic value.…”