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.
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 / Bandera, A.; Lorenzini, P.; Taramasso, L.; Cozzi-Lepri, A.; Lapadula, G.; Mussini, C.; Saracino, A.; Ceccherini-Silberstein, F.; Puoti, M.; Quiros-Roldan, E.; Montagnani, F.; Antinori, A.; d'Arminio Monforte, A.; Gori, A.; Andreoni, M.; Castagna, A.; Castelli, F.; Cauda, R.; Di Perri, G.; Galli, M.; Iardino, R.; Ippolito, G.; Lazzarin, A.; Marchetti, G. C.; Rezza, G.; von Shloesser, F.; Viale, P.; Girardi, E.; Lo Caputo, S.; Maggiolo, F.; Perno, C. F.; Bai, F.; Bonora, S.; Borderi, M.; Calcagno, A.; Capobianchi, M. R.; Cicalini, S.; Cingolani, A.; Cinque, P.; Di Biagio, A.; Gagliardini, R.; Girardi, E.; Gianotti, N.; Guaraldi, G.; Lichtner, M.; Lai, A.; Madeddu, G.; Maggiolo, F.; Merlini, E.; Nozza, S.; Piconi, S.; Pinnetti, C.; Rossotti, R.; Rusconi, S.; Santoro, M. M.; Sarmati, L.; Spagnuolo, V.; Svicher, V.; Fanti, I.; Galli, L.; Rodano', A.; Macchia, M.; Tavelli, A.; Bove, A.; Camposeragna, A.; Errico, M.; Manfredini, M.; Perziano, A.; Calvino, V.; Carletti, F.; Carrara, S.; Di Caro, A.; Graziano, S.; Petroni, F.; Prota, G.; Truffa, S.; Giacometti, A.; Costantini, A.; Barocci, V.; Angarano, G.; Monno, L.; Milano, E.; Maggiolo, F.; Suardi, C.; Viale, P.; Donati, V.; Verucchi, G.; Castelnuovo, F.; Minardi, C.; Menzaghi, B.; Abeli, C.; Chessa, L.; Pes, F.; Cacopardo, B.; Celesia, B.; Vecchiet, J.; Falasca, K.; Pan, A.; Lorenzotti, S.; Sighinolfi, L.; Segala, D.; Blanc, P.; Vichi, F.; Cassola, G.; Bassetti, M.; Alessandrini, A.; Bobbio, N.; Mazzarello, G.; Lichtner, M.; Fondaco, L.; Bonfanti, P.; Molteni, C.; Chiodera, A.; Milini, P.; Nunnari, G.; Pellicano, G.; Galli, M.; Lazzarin, A.; Rizzardini, G.; Cannizzo, E. S.; Moioli, M. C.; Piolini, R.; Bernacchia, D.; Poli, A.; Tincati, C.; Puzzolante, C.; Migliorino, C.; Sangiovanni, V.; Borgia, G.; Esposito, V.; Di Flumeri, G.; Gentile, I.; Rizzo, V.; Cattelan, A. M.; Marinello, S.; Cascio, A.; Trizzino, M.; Francisci, D.; Schiaroli, E.; Parruti, G.; Sozio, F.; Lazzaretti, C.; Corsini, R.; Qqwdreoni, Q.; Cauda, R.; Cristaudo, A.; Vullo, V.; Acinapura, R.; Lamonica, S.; Capozzi, M.; Mondi, A.; Cingolani, A.; Rivano Capparuccia, M.; Iaiani, G.; Latini, A.; Onnelli, G.; Plazzi, M. M.; De Girolamo, G.; Vergori, A.; Cecchetto, M.; Viviani, F.; Madeddu, G.; De Vito, A.; Rossetti, B.; Franco, A.; Fontana Del Vecchio, R.; Di Giuli, C.; Caramello, P.; Bonora, S.; Orofino, G. C.; Sciandra, M.; Londero, A.; Manfrin, V.; Battagin, G.; Starnini, G.; Ialungo, A.. - In: JOURNAL OF VIRAL HEPATITIS. - ISSN 1352-0504. - 28:5(2021), pp. 779-786. [10.1111/jvh.13488]
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
Castagna A.Membro del Collaboration Group
;Lazzarin A.Membro del Collaboration Group
;Rezza G.;Nozza S.;Costantini A.;Lazzarin A.Membro del Collaboration Group
;
2021-01-01
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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
