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.

Bandera, A., Lorenzini, P., Taramasso, L., Cozzi-Lepri, A., Lapadula, G., Mussini, C., et al. (2021). 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. JOURNAL OF VIRAL HEPATITIS, 28(5), 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

Lapadula G.;Puoti M.;Bonfanti P.;Molteni C.;Castagna A.;De Girolamo G.;Madeddu G.;De Vito A.;
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.
Articolo in rivista - Articolo scientifico
Scientifica
CD4; CD8; DAA; HCV/HIV; immune activation
English
Bandera, A., Lorenzini, P., Taramasso, L., Cozzi-Lepri, A., Lapadula, G., Mussini, C., et al. (2021). 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. JOURNAL OF VIRAL HEPATITIS, 28(5), 779-786 [10.1111/jvh.13488].
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; Rezza, G; von Shloesser, F; Viale, P; Castagna, A; Girardi, E; Lo Caputo, S; Maggiolo, F; Perno, C; Bai, F; Bonora, S; Borderi, M; Calcagno, A; Capobianchi, M; Castagna, A; 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; Marchetti, G; Merlini, E; Nozza, S; Perno, C; Piconi, S; Pinnetti, C; Rossotti, R; Rusconi, S; Santoro, 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; Castagna, A; Cannizzo, E; Moioli, M; 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; 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; 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; Sciandra, M; Londero, A; Manfrin, V; Battagin, G; Starnini, G; Ialungo, A
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10281/326224
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