Hepatitis C-associated autoimmunity in patients coinfected with HIV.
BACKGROUND
Hepatitis C virus (HCV) infection is associated with multiple extrahepatic manifestations. It is unclear to what extent extrahepatic manifestations occur in HIV/HCV coinfection.


METHODS
We prospectively assessed cross-sectional frequencies of autoimmune manifestations in HIV/HCV-coinfected patients (n=98), HIV-mono-infected (n=45) and HCV-mono-infected patients (n=78). Diagnostic vasculitis scores, HCV and HIV loads, CD4 cell counts, thyroid-, cardiolipin-, non-organ-specific tissue antibodies (nuclear, smooth muscle, anti-liver-kidney-microsome, neutrophil-cytoplasmic) and cryoglobulins were determined.


RESULTS
Synergistic effects of HCV and HIV infection were observed with respect to the prevalence of antibodies against thyroglobulin (HCV infection 15.4%, HIV infection 8.8%, HIV/HCV coinfection 30.6%; P<0.001) and cardiolipin antibodies (HCV infection 9.0%, HIV infection 31%, HIV/HCV coinfection 46%; P<0.001). Cryoglobulinemia type III, was significantly associated with HCV infection (HCV, 25.6%; HIV/HCV, 20.4%) but not with HIV infection (4.4%, P<0.05). Rheumatoid factor was commonly detected in patients with HCV infection (48%), but occurred considerably less frequently in patients with HIV infection (4.4%) or HIV/HCV coinfection (9.5%, P<0.01).


CONCLUSIONS
HIV coinfection appears to differentially modulate the frequency of HCV-related autoimmunity. However, autoimmunity is rarely accompanied by clinical manifestations.
Woitas
Rainer P
RP
Department of Internal Medicine I, University of Bonn, 53105 Bonn, Germany. Woitas@uni-bonn.de
Stoschus
Bodo
B
Terjung
Birgit
B
Vogel
Martin
M
Kupfer
Bernd
B
Brackmann
Hans H
HH
Rockstroh
Jürgen K
JK
Sauerbruch
Tilman
T
Spengler
Ulrich
U
D000328:Adult; D000368:Aged; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D017153:Antibodies, Anticardiolipin / Q000097:blood; D023241:Antiretroviral Therapy, Highly Active; D001323:Autoantibodies / Q000097:blood*; D001327:Autoimmune Diseases / Q000150:complications*; D003449:Cryoglobulinemia / Q000150:complications; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D006526:Hepatitis C / Q000150:complications / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012217:Rheumatoid Factor / Q000097:blood; D013954:Thyroglobulin / Q000276:immunology
D044966:Anti-Retroviral Agents; D017153:Antibodies, Anticardiolipin; D001323:Autoantibodies; D012217:Rheumatoid Factor; D013954:Thyroglobulin