Impact of treatment with direct‐acting antivirals on inflammatory markers and autoantibodies in HIV/HCV co‐infected individuals

Abstract

HCV infection could have extrahepatic manifestations due to an aberrant immune response. HCV/HIV co‐infection increases such persistent immune activation. Aim of the present study is to describe the evolution of inflammatory markers used in clinical practice, mixed cryoglobulinemia (MC) and autoantibody reactivity in co‐infected individuals who achieved sustained virological response (SVR) after DAA treatment. This prospective, observational study included all HIV/HCV co‐infected subjects who started any DAA regimen from 2015 to 2020. Samples for laboratory measurements (ferritin, C reactive protein, C3 and C4 fractions, rheumatoid factor, MC, anti‐thyroglobulin Ab, anti‐thyroid peroxidase Ab, ANCA, ASMA, anti‐LKM, anti‐DNA, AMA, ANA, T CD4+ and CD8+ cell count, and CD4/CD8 ratio) were collected at baseline, after 4 weeks, at end of treatment, and at SVR12. The analysis included 129 individuals: 51.9% with a F0–F3 fibrosis and 48.1% with liver cirrhosis. Cryocrit, C3 fraction, and rheumatoid factor significantly improved at week 4; ferritin, anti‐thyroglobulin Ab, and C4 fraction at EOT; total leukocytes count at SVR12. MC positivity decreased from 72.8% to 35.8% (p < .001). T CD4+ cell slightly increased at SVR12, but with an increase also in CD8+ resulting in stable CD4/CD8 ratio. Autoantibody reactivity did not change significantly. ANA rods and rings positivity increased from 14.8% to 28.6% (p = .099): they were observed in three subjects without exposure to RBV. DAA therapy may lead to improvement in inflammatory markers and MC clearance but without significant changes in autoantibodies reactivity and CD4/CD8 ratio over a follow up of 12 weeks.

Changes in Inflammatory Cytokines After Chronic Hepatitis C Treatment Among People Living With HIV

“…Other studies have demonstrated the impact of HCV cure on reduction in other markers predictive of non–AIDS-related complications after DAA therapy in people with HCV/HIV coinfection [ 14 ].…”

Substance use and CD4/CD8 ratio in HIV/HCV co‐infected people receiving direct‐acting antiviral treatment (ANRS CO13 HEPAVIH)

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Dear Editors,We read with great interest the recent paper by Rossotti et al which showed that direct-acting antiviral (DAA) treatment may improve inflammatory markers levels, without significant changes in CD4/ CD8 ratio, over a 12-week follow-up in HIV/hepatitis C virus (HCV) co-infected individuals. 1 The clinical utility of CD4/CD8 ratio monitoring in people living with HIV (PLWH) is increasingly recognized, especially among individuals with controlled infection. 2 Substance (including tobacco, alcohol and cannabis) use, frequently reported by PLWH, is rarely cited as a determinant of CD4/CD8 variations, 2 while it may impact CD4 and CD8 cell counts.

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