Short communication: impact of hepatitis C viral clearance on CD4+ T-lymphocyte course in HIV/HCV-coinfected patients treated with pegylated interferon plus ribavirin.

Abstract

The long-term impact of pegylated-interferon plus ribavirin (Peg-IFN-RBV) treatment outcome on CD4 T cell course in patients coinfected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) is unknown. The aim of this study was to investigate the impact of HCV-RNA clearance by standard anti-HCV therapy on long-term CD4 cells recovery in HIV/HCV patients on successful combined antiretroviral therapy (cART). We retrospectively enrolled HIV/HCV-coinfected patients on stable cART, treated with Peg-IFN-RBV between 2005 and 2009. CD4(+) T cell counts were registered at baseline (pre-Peg-IFN-RBV), after 6, 12, and 24 months of follow-up from therapy discontinuation. Multiple linear regression analysis was performed to identify independent predictors of CD4(+) T cell change following the anti-HCV treatment outcome. Of the 116 patients enrolled, 54 (46.6%) reached a sustained virological response (SVR) and 62 (53.4%) did not. Throughout a median follow-up of 24 months, the SVR group showed a mean annual increase in CD4(+) T cell from baseline of 84 cells/μl at 1 year and of a further 38 cells/μl within the second year (p=0.01, 0.001, respectively). A nonsignificant mean increase of 77 cells/μl occurred in the non-SVR group within month 24 (p=0.06). Variables associated with greater CD4 gains were higher nadir and lower pre-interferon CD4 counts, and lower body mass index (BMI). The achievement of SVR was not significantly associated with the change in CD4(+) count. The clearance of HCV replication did not affect the CD4(+) changes after Peg-IFN-RBV therapy in coinfected patients on efficient cART. Liver fibrosis and higher BMI were negative determinants of immune recovery.

• Authors: Laura Milazzo, Antonella Foschi, Cristina Mazzali, Anita Viola, Annalisa Ridolfo, Massimo Galli, Spinello Antinori
• Journal: AIDS research and human retroviruses (AIDS Res Hum Retroviruses) Vol. 28 Issue 9 Pg. 989-93 (Sep 2012) ISSN: 1931-8405 [Electronic] United States
• PMID: 22220723 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antiviral Agents
• Interferon alpha-2
• Interferon-alpha
• RNA, Viral
• Recombinant Proteins
• Polyethylene Glycols
• Ribavirin
• peginterferon alfa-2b

Topics

• Acquired Immunodeficiency Syndrome (drug therapy, immunology)
• Adult
• Antiviral Agents (administration & dosage, therapeutic use)
• CD4 Lymphocyte Count
• Coinfection
• Drug Therapy, Combination
• Female
• Hepatitis C, Chronic (drug therapy, immunology)
• Humans
• Interferon alpha-2
• Interferon-alpha (therapeutic use)
• Male
• Polyethylene Glycols (therapeutic use)
• RNA, Viral (drug effects)
• Recombinant Proteins (therapeutic use)
• Ribavirin (therapeutic use)
• Treatment Outcome
• Viral Load (drug effects)