4.5 Article

Modifications of CD4 T cells, CD4/CD8 ratio and serum levels of soluble CD14 in HIV-HCV-coinfected patients after sustained HCV response induced by direct-acting antiviral agents: influence of liver cirrhosis

Journal

Publisher

SPRINGER
DOI: 10.1007/s10096-021-04237-y

Keywords

HIV infection; Hepatitis C virus; CD4 T cells; CD8 T cells; CD4; CD8 ratio; Soluble CD14; Direct-acting antiviral agents; Sustained viral response

Funding

  1. Secretaria General de Investigacion, Desarrollo e Innovacion en Salud, Junta de Andalucia, Iniciativa Territorial Integrada 2014-2020 para la provincia de Cadiz, Spain [PI-0076-2017]
  2. FEDER (Fondo Europeo de Desarrollo Regional)

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The study analyzed the changes in CD4 T cell modifications, CD4/CD8 ratio, and serum levels of sCD14 in HIV/HCV-coinfected patients after treatment with direct anti-HCV antiviral agents. Results showed significant increases in CD4 T cell count and percentage only in individuals without liver cirrhosis, supporting the idea that treatment against HCV in HIV/HCV-coinfected patients is needed in the early phases of liver disease.
To analyze the modifications of CD4 T cell, CD4/CD8 ratio, and serum levels of soluble CD14 (sCD14) in HIV/HCV-coinfected patients after treatment with direct anti-HCV antiviral agents. Consecutive cases of HIV/HCV-coinfected patients, attended at the University Hospital, who achieved sustained virological responses with interferon-free hepatitis C antiviral drugs, were analyzed. Thirty-five percent of patients (n = 39) had been diagnosed with liver cirrhosis. The evaluation criteria were changes in CD4 T-cell counts and percentages and inflammation (measured by serum sCD14 levels) or immune activation indexes (determined by CD4/CD8 ratio) from beginning anti-HCV therapy to 12 months later. One hundred twelve patients were included (87% male; median age, 54 years; median time from the infection diagnosis, 22 years; previous drug users, 87%). Significant increases in CD4 T cell count and percentage were detected only in individuals without liver cirrhosis. No significant differences in CD4/CD8 ratios or sCD14 levels were observed in patients with or without cirrhosis. The proportion of patients with less than 500 CD4 T cell/mm(3) before therapy who achieved more than 500 CD4 T cell/mm(3) after it increased only in the group without liver cirrhosis. The finding that CD4 T cell count and percentage were improved only in patients without liver cirrhosis supports the idea that treatment against HCV in HIV/HCV-coinfected patients is needed in the early phases of liver disease.

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