Hepatitis C Viremia Is Associated with Cytomegalovirus IgG Antibody Levels in HIV-Infected Women

Abstract

BackgroundIndividuals with HIV infection exhibit high cytomegalovirus (CMV) IgG levels, but there are few data regarding the association of hepatitis C virus (HCV) with the immune response against CMV.MethodsAssociations of HCV with CMV seropositivity and CMV IgG levels were studied in 635 HIV-infected women, 187 of whom were HCV-seropositive, with adjustment in multivariable models for age, race/ethnicity, and HIV disease characteristics. Eighty one percent of the women reported receipt of highly active antiretroviral therapy (HAART) prior to or at CMV testing.ResultsIn adjusted models women with chronic HCV had higher CMV IgG levels than those without HCV RNA (β = 2.86, 95% CI:0.89 – 4.83; P = 0.004). The association of HCV RNA with CMV IgG differed by age (P interaction = 0.0007), with a strong association observed among women in the low and middle age tertiles (≤45.3 years of age; β = 6.21, 95% CI:3.30 – 9.11, P<0.0001) but not among women in the high age tertile. CMV IgG levels were not associated with non-invasive measures of liver disease, APRI and FIB-4, or with HCV RNA level and adjustment for Epstein-Barr virus (EBV) IgG levels did not affect the association between HCV and CMV.ConclusionsCMV IgG levels are higher in HCV/HIV co-infected women than in HIV mono-infected women. Further research on the association of HCV with CMV IgG is indicated because prior studies have found CMV IgG to be associated with morbidity and mortality in the general population and subclinical carotid artery disease in HIV-infected patients.

Coinfection of Cytomegalovirus (Immunoglobulin G) Antibody in Anti-hepatitis C Virus Seropositive Cases at a Tertiary Care Hospital

“…In the present study, the anti-CMV IgG positivity rate among the HCV-infected patients (Group A) was 88% which was comparable to the previous studies. [2,6,7] The anti-CMV IgG prevalence in the general population (Group B) was 75.2% which was also comparable to the previous studies. [8][9][10] Looking at the age distribution of the anti-CMV IgG-positive cases in Group A, 46 (92%) cases were in the age group of >40-60 years, 43 (86%) cases were in the age group of 18-40 years, and 21 (84%) cases were in the age group of >60-85 years.…”

“…[1] CMV is a human β herpesvirus with tropism for a wide range of cell types in which life long, persistent infection is established. [2] Hepatitis C virus (HCV) infection has a highly variable natural course and it ranges clinically from asymptomatic to fulminate and with regard to the status of infection from silent to self-limited to viremia. [3] CMV (immunoglobulin G [IgG]) and HCV coinfection -CMV infection enhances HCV pathogenesis as it prevents the normal mechanisms which are responsible for HCV clearance, thus plays a key role in HCV persistence and pathogenicity.…”

Immunopathology of CMV Co-Infection: Review

“…This notion is supported of by the fact that peripheral dendritic and naive CD4 + T-cells are reduced both in number and function in individuals with chronic HCV [77,78], Peripheral CD4 + T-cell numbers are also reduced in patients with HCV-associated cirrhosis. Therefore, chronic HCV infection will affect the immune response against CMV in a similar fashion to that seen withhold age and HIV infection [79]. In liver transplant patients and those receiving HCV antiviral therapy the association of HCV with CMV pathogenesis is documented [80,81].…”

Serological and Immunohistochemical Prevalence of Human Cytomegalovirus Co-infection among Hepatitis C Virus Patients Admitted to Kafer El Shiekh Liver and Heart Institute, Egypt

“…Prevalence of CMV among HCV patients using IHC was 70% from Liver and Digestive System Technical Hospital in Baghdad, Iraq [39]. Moreover, CMV IgG levels were highly detected in HCV/HIV co-infected women compared to HIV mono-infected women [40].…”