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Lorenzini, Patrizia; Taramasso, Lucia; Lapadula, Giuseppe; Saracino, Annalisa; Ceccherini‐Silberstein, Francesca; Quiros‐Roldan, Eugenia; Antinori, Andrea; d’Arminio Monforte, A.; Gori, Andrea; Andreoni, M; Castagna, A; Galli, M; Ippolito, G; Lazzarin, A; Marchetti, GC; Rezza, G; Viale, P; Maggiolo, F; Bai, F; Castagna, A; Cingolani, A; Di Biagio, A; Gagliardini, R; Girardi, E; Lai, A; Madeddu, G; Maggiolo, F; Marchetti, G; Perno, CF; Pinnetti, C; Rusconi, S; Sarmati, L; Spagnuolo, V; Galli, L; Macchia, M; Tavelli, A; Errico, M; Manfredini, M; Perziano, A; Calvino, V; Carrara, S; Di Caro, A; Graziano, S; Petroni, F; Costantini, A; Angarano, G; Maggiolo, F; Suardi, C; Viale, P; Verucchi, G; Minardi, C; Chessa, L; Pes, F; Cacopardo, B; Vecchiet, J; Falasca, K; Pan, A; Sighinolfi, L; Bassetti, M; Alessandrini, A; Bobbio, N; Fondaco, L; Milini, P; Nunnari, G; Pellicanò, G; Rizzardini, G; Poli, A; Tincati, C; Puzzolante, C; Sangiovanni, V; Esposito, V; Gentile, I; Rizzo, V; Cattelan, AM; Marinello, S; Cascio, A; Trizzino, M; Francisci, D; Lazzaretti, C; Corsini, R; Cauda, R; Vullo, V; Acinapura, R; Lamonica, S; Capozzi, M; Rivano Capparuccia, M; Iaiani, G; Viviani, F; De Vito, A; Rossetti, B; Fontana Del Vecchio, R; Di Giuli, C; Caramello, P; Di Perri, G; Bonora, S; Sciandra, M; Londero, A; Manfrin, V; Battagin, G; Ialungo, A
Journal of viral hepatitis, 20/May , Volume: 28, Issue: 5Journal Article
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.
