Spontaneous HCV clearance in HCV/HIV-1 coinfection associated with normalized CD4 counts, low level of chronic immune activation and high level of T cell function.

BACKGROUND/OBJECTIVE: Spontaneous HCV clearance in HCV/HIV-1 coinfected patients is likely to be very rare given the damage to the immune system caused by HIV-1 infection. The search for immune correlates of spontaneous clearance is important for the understanding of pathogenesis as well as for the development of possible new treatment strategies. STUDY DESIGN/RESULTS: A cohort of HCV/HIV-1 coinfected patients was followed. Plasma HCV viral load was measured and T cell immunity in peripheral blood samples was assessed using multi-color flow cytometry. One HCV/HIV-1 coinfected patient spontaneously became HCV-RNA negative after being positive for several years. This patient displayed a normalized CD4 counts on successful HAART, low level of T cell activation and a high level of T cell function as compared to HCV/HIV-1 coinfected control subjects. CONCLUSIONS: A beneficial immune status including a low level of chronic T cell activation and a high level of T cell function may be one factor that contributes to improved chances of clearance of chronic HCV infection in HIV-1 infected patients.