학술논문
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.
Document Type
Article
Author
Bandera, Alessandra; Lorenzini, Patrizia; Taramasso, Lucia; Cozzi‐Lepri, Alessandro; Lapadula, Giuseppe; Mussini, Cristina; Saracino, Annalisa; Ceccherini‐Silberstein, Francesca; Puoti, Massimo; Quiros‐Roldan, Eugenia; Montagnani, Francesca; Antinori, Andrea; d'Arminio Monforte, A.; Gori, Andrea; Andreoni, M; Castagna, A; Castelli, F; Cauda, R; Di Perri, G; Galli, M
Source
Subject
*MIXED infections
*HIV
*HIV-positive persons
*RIBAVIRIN
*
*
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Language
ISSN
1352-0504
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. [ABSTRACT FROM AUTHOR]