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

Bandera A.;Taramasso L.;d'Arminio Monforte A.;Gori A.;Ippolito G.;Lazzarin A.;Marchetti G. C.;Perno C. F.;Bai F.;Bonora S.;Piconi S.;Rossotti R.;Rusconi S.;Macchia M.;Errico M.;Manfredini M.;Milano E.;Suardi C.;Menzaghi B.;Segala D.;Alessandrini A.;Bonfanti P.;Lazzarin A.;Cannizzo E. S.;Moioli M. C.;Piolini R.;Bernacchia D.;Tincati C.;
2021-05

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.
CD4; CD8; DAA; HCV/HIV; immune activation; Antiviral Agents; CD4 Lymphocyte Count; CD4-Positive T-Lymphocytes; CD8-Positive T-Lymphocytes; Female; Hepacivirus; Humans; Middle Aged; Coinfection; HIV Infections; Hepatitis C
Settore MED/17 - Malattie Infettive
mar-2021
JOURNAL OF VIRAL HEPATITIS
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/898517
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