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.
Center for the Study of Hepatitis C, Department of Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA.
P Wilfredo
PW
Canchis
Herman T
HT
Yee
M Isabel
MI
Fiel
Douglas T
DT
Dieterich
Ruei-Che
RC
Liu
Luis
L
Chiriboga
Ira M
IM
Jacobson
Brian R
BR
Edlin
Andrew H
AH
Talal
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