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Influence of Hepatitis C virus coinfection on immune reconstitution in HIV subjects

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Abstract

Despite successful HIV suppression by antiretroviral treatment (ART), immune activation may persist in HIV patients, contributing to an impaired immunological reconstitution and disease progression. Information regarding Hepatitis C virus (HCV) coinfection as a factor that accounts for immune activation in HIV subjects remains unclear. Furthermore, most studies have been carried out considering HIV/HCV patients as a whole, without taking into account the presence or absence of liver damage. Therefore, it is unknown if HCV and/or its liver-related disease could act as two independent factors contributing to the immune activation. In this study, we investigated the presence of immune activation in a cohort of 50 HIV/HCV patients by measuring cytokine levels, CD4+ T-cell counts and CD4/CD8 ratios. Six patient groups were defined according to HIV viral load, HCV status, and liver disease to assess the impact of each of these factors on immune activation and reconstitution in HIV/HCV patients. Only subjects with controlled HIV infection and cleared HCV displayed immunological parameters within normal ranges. The mere presence of HCV contributes to immune activation leading to an inappropriate immunological reconstitution. This state exacerbates in the presence of HCV-associated liver disease. Our results suggest that ART is not enough to suppress immune activation in the context of HIV/HCV coinfection, since both HCV and its liver-related disease would contribute to the immune activation. Given that immune activation worsens immunological reconstitution and clinical status, these results support the priority of HCV treatment in HIV/HCV patients and suggest the monitoring of their liver status.

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Acknowledgements

The authors would like to thank Nora Galassi, Norma Riera, and Marta Felippo for flow cytometry data acquisition. We would like to thank the staff of the Fundación de la Hemofilia and to the patients enrolled in this study for their participation and cooperation. We are indebted to Fundación René Baron for the generous financial supports that enabled some aspects of this work.

Funding

This study was supported by grants from the Fundación Alberto J. Roemmers and CONICET (PIP 11220120100619CO).

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Authors and Affiliations

  1. Laboratory of Immunology, Instituto de Medicina Experimental (IMEX)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Academia Nacional de Medicina, J.A. Pacheco de Melo 3081, CABA 1425, Buenos Aires, Argentina

    María Noel Badano, Cecilia Parodi, Natalia Aloisi, María Marta Elizalde de Bracco & Patricia Baré

  2. Fundación de la Hemofilia, Soler 3483, CABA 1174, Buenos Aires, Argentina

    Marcelo Corti

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  1. María Noel Badano
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  2. Cecilia Parodi
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Correspondence to María Noel Badano.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Edited by: Christian Bogdan.

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Badano, M.N., Parodi, C., Aloisi, N. et al. Influence of Hepatitis C virus coinfection on immune reconstitution in HIV subjects. Med Microbiol Immunol 208, 747–756 (2019). https://doi.org/10.1007/s00430-019-00619-4

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  • DOI: https://doi.org/10.1007/s00430-019-00619-4

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