Impact of hepatitis C virus coinfection on immune restoration during successful antiretroviral therapy in chronic human immunodeficiency virus type 1 disease

Abstract

The effect of coinfection with hepatitis C virus (HCV) on immune restoration in 39 human immunodeficiency virus (HIV)-infected patients during treatment with combined antiretroviral therapy (cART) was prospectively evaluated. After 48 weeks of treatment, HCV-coinfected patients had lower increases in CD4% (P = .05), total CD4+ (P = .01), and naïve CD4+ (P = .06) T cells than did single-infected subjects. Higher baseline naïve CD4+ T-cell levels were associated with better CD4+ (P = .05) and naïve CD4+ (P < .001) T-cell recovery. After a 4-year follow up, the differences disappeared (median CD4+ increase: 291 and 306 cells for HCV-positive and HCV-negative patients, respectively, P = .9). No significant differences were seen in memory CD4+ T cells (P = .30), and CD8+ cells expressing CD38 (P = .10) and CD28 (P = .73). These results suggest that, independently of other factors, infection with HCV blunts early CD4+ T-cell recovery in HIV-infected patients treated with combined antiretroviral therapy (cART). However, as good control of viral replication is maintained, satisfactory long-term immune restoration can nonetheless be achieved.

Chronic immune activation and decreased CD4 cell counts associated with hepatitis C infection in HIV-1 natural viral suppressors

“…Specifically, studies have shown that the presence of HCV can blunt the CD4 recovery. Though there is not agreement on all studies whether HCV coinfection leads to decreased number of CD4 cell recovery [15–23], there does appear to be a delayed CD4 reconstitution associated with HIV/HCV coinfected patients undergoing HAART therapy [24–27]. In addition, HCV infection has been cited as a risk factor for developing an AIDS-defining illness [28].…”

Multiple viral coinfections among HIV/AIDS patients in China

“…HBV and HCV are of concerns because both viruses compromise liver function, which may further affect the metabolism and therapeutic effect of antiretroviral drugs (ARV) for AIDS patients (11)(12)(13). They are also classified as group one causative agents of hepatocellular carcinoma (HCC) by International Agency for Research on Cancer (IARC).…”

Evaluation of the possible influence of hepatitis C virus and liver fibrosis on HIV type 1 immunological and virological outcomes

“…In contrast, the role of HCV coinfection in the clinical and viroimmunological outcomes of HIV‐1 infection is controversial and has not yet been elucidated despite the many studies published. Some studies have reported poorer immunological [3–15] and clinical outcomes [2,4–6,16–21] in patients coinfected with HIV‐1/HCV as compared with HIV‐1‐monoinfected patients, whereas others found that there were no differences in immunological [3,19–35], virological [4–8,31–34] and clinical endpoints [1,7,28–33,36,37] between these two groups.…”