Intrahepatic CD4+ cell depletion in hepatitis C virus/HIV-coinfected patients.
Coinfection with HIV and hepatitis C virus (HCV)-specific immune responses, increases hepatic inflammation, accelerates hepatic fibrosis, and is associated with deceased treatment responses. We quantified intrahepatic lymphocyte and hepatocyte phenotypes in HCV-infected patients with (n = 38) and without (n = 41) HIV infection. A single pathologist counted positive cells in 5 portal and 5 lobular areas. Coinfected patients had 6.81 +/- 1.9 fewer CD4 cells per portal field (10.58 +/- 1.12 vs. 4.97 +/- 1.09 cells/high-power field [HPF]; P < 0.001) and 0.48 +/- 0.15 more apoptotic lymphocytes per lobular field (0.16 +/- 0.06 vs. 0.64 +/- 0.15 cell/HPF; P = 0.002) than monoinfected patients. The number of portal CD4 cells was not associated with the peripheral CD4 cell number. Portal and lobular CD8 cells did not differ between the 2 groups. Portal proliferative hepatocytes were increased in coinfected patients with HIV RNA levels of >400 copies/mL (1.13 +/- 0.32 cells/HPF; P = 0.01) compared with those with undetectable HIV RNA (0.46 +/- 0.09 cell/HPF) and monoinfected patients (0.45 +/- 0.08 cell/HPF). In conclusion, HIV coinfection is associated with fewer portal CD4 cells and increased lobular lymphocyte apoptosis that may impact on the natural history of HCV infection.
Canchis
P Wilfredo
PW
Center for the Study of Hepatitis C, Department of Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA.
Yee
Herman T
HT
Fiel
M Isabel
MI
Dieterich
Douglas T
DT
Liu
Ruei-Che
RC
Chiriboga
Luis
L
Jacobson
Ira M
IM
Edlin
Brian R
BR
Talal
Andrew H
AH
D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D002455:Cell Division; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000276:immunology; D016174:Hepacivirus / Q000276:immunology; D006526:Hepatitis C / Q000150:complications* / Q000276:immunology / Q000821:virology; D022781:Hepatocytes / Q000502:physiology; D006801:Humans; D016130:Immunophenotyping; D008099:Liver / Q000276:immunology* / Q000473:pathology; D008213:Lymphocyte Activation; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged