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. - STAMPA. - 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
Verucchi G.Membro del Collaboration Group
;
2021
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.
