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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
Author(s) -
Bandera Alessandra,
Lorenzini Patrizia,
Taramasso Lucia,
CozziLepri Alessandro,
Lapadula Giuseppe,
Mussini Cristina,
Saracino Annalisa,
CeccheriniSilberstein Francesca,
Puoti Massimo,
QuirosRoldan Eugenia,
Montagnani Francesca,
Antinori Andrea,
d’Arminio Monforte A.,
Gori Andrea
Publication year - 2021
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.13488
Subject(s) - cd8 , medicine , ribavirin , cd4 cd8 ratio , gastroenterology , human immunodeficiency virus (hiv) , cohort , hepatitis c virus , viral load , antiretroviral therapy , immunology , virus , immune system , lymphocyte subsets
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/mm 3 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/mm 3 (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/mm 3 , 95%CI −375.0;‐33.4, p = 0.019), while patients treated with RBV experienced CD8 + cell increase (+141.2 cells/mm 3 , 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.