The impact of DAA-mediated HCV eradication on CD4+ and CD8+ T lymphocyte trajectories in HIV/HCV coinfected patients: Data from the ICONA Foundation Cohort.
J Viral Hepat
; 28(5): 779-786, 2021 05.
Article
em En
| MEDLINE
| ID: mdl-33600068
ABSTRACT
HCV infection has been hypothesized as a contributor of poor CD4+ recovery in patients living with HIV (PLWHIV). Aim of this study was to evaluate CD4+ , CD8+ cells and CD4/CD8 ratio trends before and after HCV treatment with direct acting agents (DAA) in PLWHIV. HIV/HCV patients enrolled in ICONA and HepaICONA cohorts with HIV-RNA≤50 copies/ml who achieved a sustained viral response after DAA treatment were studied. A linear regression model was used to investigate CD4+ , CD8+ and CD4/CD8 changes 12 months before and after DAA treatment. A total of 939 HIV/HCV patients were included, 225 (24.0%) female, median age 53 years (IQR 50-56). At DAA initiation, CD4+ T cell count was <350 cells/mm3 in 164 patients (17.5%), and 246 patients (26.2%) had liver stiffness>12.5 kPa. Trends of CD4+ and CD4/CD8 ratio were similar before and after DAA in all study populations (CD4+ change +17.6 cells/mm3 (95%CI -33.5; 69.4, p = 0.494); CD4/CD8 change 0.013 (95%CI -0.061; 0.036, p = 0.611). However, patients treated with ribavirin (RBV)-free DAA showed a significant decrease in CD8+ cells (-204.3 cells/mm3 , 95%CI -375.0;-33.4, p = 0.019), while patients treated with RBV experienced CD8+ cell increase (+141.2 cells/mm3 , 95%CI 40.3; 242.1, p = 0.006). In conclusion, HCV eradication following DAA treatment does not seem to have an impact on CD4+ T cell recovery in PLWHIV. However, a fast decline of CD8+ T cells has been observed in patients treated without RBV, suggesting a favourable effect of HCV clearance on the general state of immune activation.
Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Infecções por HIV
/
Hepatite C
/
Coinfecção
Tipo de estudo:
Risk_factors_studies
Limite:
Female
/
Humans
/
Middle aged
Idioma:
En
Revista:
J Viral Hepat
Assunto da revista:
GASTROENTEROLOGIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Itália