Skip to main content

Advertisement

SpringerLink
Log in

Impaired Recovery of CD4+ Cell Counts Following Highly Active Antiretroviral Therapy in Drug-Naïve Patients Coinfected with Human Immunodeficiency Virus and Hepatitis C Virus

  • Article
  • Published:
European Journal of Clinical Microbiology and Infectious Diseases Aims and scope Submit manuscript

Abstract

Coinfection with the human immunodeficiency virus (HIV) and the hepatitis C virus (HCV) is highly prevalent in southern Europe. However, there are few and contradictory data about the effect of HCV carriage on the response to highly active antiretroviral therapy (HAART). In this study, the recovery of CD4+ T cells following HAART among antiretroviral-naïve patients seropositive for HIV with and without HCV coinfection was investigated. Two hundred one HIV-infected patients without previous exposure to antiretroviral drugs were included in the study. HCV coinfection was detected in 123 (61%) patients. The time to recover 200 CD4+ cells/µl was longer in the HCV-positive group (P<0.001). In a Cox model, HCV infection and lack of persistent HIV viremia (defined as <200 copies/ml) were associated with the time to recover 200 CD4+ cells/µl. The mean increase in CD4+ cell counts was lower in the HCV-positive group during the first year of therapy. HIV/HCV-coinfected patients naïve for antiretroviral therapy show a delayed recovery of CD4+ cell counts after starting HAART.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Sherman KE, Rouster SD, Raymond TC, Rejicic N (2002) Hepatitis C virus prevalence among patients infected with human immunodeficiency virus: a cross-sectional analysis of the U.S. Adult AIDS Clinical Trials Group. Clin Infect Dis 34:831–837

    Article  PubMed  Google Scholar 

  2. Macías J, Pineda JA, Leal M, Abad MA, García-Pesquera F, Delgado J, Gallardo JA, Sánchez-Quijano A, Lissen E (1998) Influence of hepatitis C virus infection on the mortality of antiretroviral-treated patients with HIV disease. Eur J Clin Microbiol Infect Dis 17:167–170

    PubMed  Google Scholar 

  3. Greub G, Ledergerber B, Battegay M, Grob P, Perrin L, Furrer H, Burgisser P, Erb P, Boggian K, Piffaretti JC, Hirschel B, Janin P, Francioli P, Flepp M, Telenti A (2000) Clinical progression, survival, and immune recovery during antiretroviral therapy in patients with HIV-1 and hepatitis C virus coinfection: the Swiss HIV Cohort Study. Lancet 356:1800–1805

    CAS  PubMed  Google Scholar 

  4. Macías J, Pineda JA, Leal M, Lissen E (2001) HIV-1 progression in hepatitis-C-infected drug users. Lancet 357:1362–1363

    CAS  PubMed  Google Scholar 

  5. De Luca A, Bugarini R, Lepri AC, Puoti M, Girardi E, Antinori A, Poggio A, Pagano G, Tositti G, Cadeo G, Macor A, Toti M, D’Arminio Monforte A (2002) Coinfection with hepatitis viruses and outcome of initial antiretroviral regimens in previously naive HIV-infected subjects. Arch Intern Med 162:2125–2132

    Article  PubMed  Google Scholar 

  6. Macías J, Melguizo I, Fernández-Rivera FJ, García-García A, Mira JA, Ramos AJ, Rivera JM, Pineda JA (2002) Mortality due to liver failure and impact on survival of hepatitis virus infections in HIV-infected patients on potent antiretroviral therapy. Eur J Clin Microbiol Infect Dis 21:775–781

    Article  PubMed  Google Scholar 

  7. Sulkowski MS, Moore RD, Mehta SH, Chaisson RE, Thomas DL (2002) Hepatitis C and progression of HIV disease. JAMA 288:241–243

    PubMed  Google Scholar 

  8. Chung RT, Evans SR, Yang Y, Theodore D, Valdez H, Clark R, Shikuma C, Nevin T, Sherman KE (2002) Immune recovery is associated with persistent rise in hepatitis C virus RNA, infrequent liver test flares, and is not impaired by hepatitis C virus in co-infected subjects. AIDS 16:1915–1923

    Article  PubMed  Google Scholar 

  9. Franco JM, León-Leal JA, Leal M, Cano-Rodríguez A, Pineda JA, Macías J, Rubio A, Rey C, Sánchez B, Lissen E (2000) CD4+ and CD8+ T-lymphocyte regeneration after anti-retroviral therapy in HIV-1-infected children and adult patients. Clin Exp Immunol 119:493–498

    Article  PubMed  Google Scholar 

  10. Radkowski M, Wang LF, Vargas H, Rakela J (1998) The presence of active hepatitis C virus replication in lymphoid tissue in patients coinfected with human immunodeficiency virus type 1. J Infect Dis 178:1189–1192

    PubMed  Google Scholar 

  11. Lerat H, Berby F, Trabaud MA, Vidalin O, Major M, Trepo C, Inchauspe G (1996) Specific detection of hepatitis C virus minus strand RNA in hematopoietic cells. J Clin Invest 97:845–851

    PubMed  Google Scholar 

  12. Lau JY, Xie X Lai MM, Wu PC (1998) Apoptosis and viral hepatitis. Semin Liver Dis 18:169–176

    PubMed  Google Scholar 

  13. Taya N, Torimoto Y, Shindo M, Hirai K, Hasebe C, Kohgo Y (2000) Fas-mediated apoptosis of peripheral blood mononuclear cells in patients with hepatitis C. Br J Haematol 110:89–97

    Article  PubMed  Google Scholar 

  14. Macías J, Sánchez-Quijano A, Pineda JA, Abad MA, Rubio A, Rosa R, Leal M, Lissen E (2001) Minimal liver injury in chronic hepatitis C virus infection is associated with low levels of soluble TNF-α/Fas receptors and acquisition at childhood. Liver 21:410–440

    Article  PubMed  Google Scholar 

  15. Centers for Disease Control (1992) 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMWR 41:1–19

    Google Scholar 

  16. Moreno A, Pérez-Elias MJ, Casado JL, Muñoz V, Antela A, Dronda F, Navas E, Fortún J, Quereda C, Moreno S (2000) Effectiveness and pitfalls of initial highly active antiretroviral therapy in HIV-infected patients in routine clinical practice. Antivir Ther 5:243–248

    PubMed  Google Scholar 

  17. Lucas GM, Cheever LW, Chaisson RE, Moore RD (2001) Detrimental effects of continued illicit drug use on the treatment of HIV-1 infection. J Acquir Immune Defic Syndr 27:251–259

    PubMed  Google Scholar 

  18. Fuente L de la, Bravo MJ, Lew C, Barrio G, Soriano V, Royuela L (1999) Prevalencia de infección por el virus de la inmunodeficiencia humana y de conductas de riesgo entre los consumidores de heroína de Barcelona, Madrid, Sevilla: un ejemplo de las ventajas de centrar los estudios en los consumidores y no solo en los usuarios de drogas por vía intravenosa. Med Clin (Barc) 113:646–651

    Google Scholar 

  19. Eyster ME, Diamondstone LS, Lien JM, Ehmann WC, Quan S, Goedert (1993) Natural history of hepatitis C virus infection in multitransfused hemophiliacs: effect of coinfection with human inmunodeficiency virus. J Acquir Immune Defic Syndr 6:602–610

    CAS  PubMed  Google Scholar 

  20. Puoti M, Gargiulo F, Roldan EQ, Chiodera A, Palvarini L, Spinetti A, Zaltron S, Putzolu V, Zanini B, Favilli F, Turano A, Carosi G (2000) Liver damage and kinetics of hepatitis C virus and human immunodeficiency virus replication during the early phases of combination antiretroviral treatment. J Infect Dis 181:2033–2036

    CAS  PubMed  Google Scholar 

  21. García-García JA, Mira JA, Fernández-Rivera J, Ramos A, Vargas J, Macías J, Pineda JA (2003) Failure to achieve normal serum β2 microglobulin levels in HIV-infected patients receiving highly active antiretroviral therapy. Influence of hepatitis C virus coinfection. Eur J Clin Microbiol Infect Dis 22:194–196

    PubMed  Google Scholar 

  22. Copeland KFT, Heeney JL (1996) T helper cell activation and human retroviral pathogenesis. Microbiol Rev 60:722–742

    CAS  PubMed  Google Scholar 

  23. Toubi E, Kessel A, Goldstein L, Slobodin G, Sabo E, Shmuel Z, Zuckerman E (2001) Enhanced peripheral T-cell apoptosis in chronic hepatitis C virus infection: association with liver disease severity. J Hepatol 35:774–780

    Article  PubMed  Google Scholar 

  24. Xiang J, Wunschmann S, Diekema DJ, Klinzman D, Patrick KD, George SL, Stapleton JT (2001) Effect of coinfection with GB virus C on survival among patients with HIV infection. N Engl J Med 345:707–714

    CAS  PubMed  Google Scholar 

  25. Tillmann HL, Heiken H, Knapik-Botor A, Heringlake S, Ockenga J, Wilber JC, Goergen B, Detmer J, McMorrow M, Stoll M, Schmidt RE, Manns MP (2001) Infection with GB virus C and reduced mortality among HIV-infected patients. N Engl J Med 345:715–724

    CAS  PubMed  Google Scholar 

  26. Brumme ZL, Chan KJ, Dong WW, Mo T, Wynhoven B, Hogg RS, Montaner JS, O’Shaughnessy MV, Harrigan PR (2002) No association between GB virus C viremia and virological or immunological failure after starting initial antiretroviral therapy. AIDS 16:1929–1933

    Article  PubMed  Google Scholar 

  27. Soriano V, Sulkowski M, Bergin C, Hatzakis A, Cacoub P, Katlama C, Cargnel A, Mauss S, Dieterich D, Moreno S, Ferrari C, Poynard T, Rockstroh J (2002) Care of patients with chronic hepatitis C and HIV co-infection: recommendations from the HIV-HCV International Panel. AIDS 16:813–828

    Article  PubMed  Google Scholar 

  28. Landau A, Batisse D, Piketty C, Duong Van Huyen JP, Bloch F, Belec L, Bruneval P, Weiss L, Jian R, Kazatchkine MD (2000) Efficacy and safety of combination therapy with interferon-alpha 2b and ribavirin for chronic hepatitis C in HIV-infected patients. AIDS 14:839–844

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This study was partly supported by grants from Servicio Andaluz de Salud (SAS 01/98), Fondo de Investigación Sanitaria (FIS, PI021726), and Fundació Barcelona SIDA 2002 (ref. 05/2003).

Author information

Authors and Affiliations

  1. Servicio de Medicina Interna, Hospital Universitario de Valme, Carretera de Cádiz s/n, 41014, Seville, Spain

    J. Macías, J. A. Pineda, A. Ramos, J. A. García-García, J. Fernández-Rivera & J. A. Mira

  2. Unidad de Enfermedades Infecciosas, Hospital Universitario de Valme, Carretera de Cádiz s/n, 41014, Seville, Spain

    J. A. Pineda, F. Lozano, J. E. Corzo, E. León & J. Gómez-Mateos

Authors
  1. J. Macías
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. A. Pineda
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F. Lozano
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. E. Corzo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. Ramos
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. E. León
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. J. A. García-García
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. J. Fernández-Rivera
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. J. A. Mira
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. J. Gómez-Mateos
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. A. Pineda.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Macías, J., Pineda, J.A., Lozano, F. et al. Impaired Recovery of CD4+ Cell Counts Following Highly Active Antiretroviral Therapy in Drug-Naïve Patients Coinfected with Human Immunodeficiency Virus and Hepatitis C Virus. Eur J Clin Microbiol Infect Dis 22, 675–680 (2003). https://doi.org/10.1007/s10096-003-1015-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-003-1015-2

Keywords

Search

Navigation