Pathogenesis of liver damage in HCV-HIV patients.
The coinfection of HIV and HCV has become a pathology with several distinctive characteristics. Pathogenesis of liver damage in patients with HIV and HCV coinfection is complex and multifactorial. It derives from a balance of factors which interact among themselves in a dynamic way. The reasons for the accelerated course of HIV/HCV coinfection are mainly related to two principal causes: the persistence of HCV, which depends upon alterations of cell-mediated immunity, and the activation of the immune system towards secretion of proinflammatory and profibrotic cytokines. This review will first focus on the characteristics of both these immune-mediated mechanisms, and then their implication on fibrogenesis as well as on other pathogenetic mechanisms, such as interactions between viruses and the deficit of protective mechanisms. A better knowledge of adaptive immune mechanisms, cytokine alteration, interference with host defense mechanisms, and the "cross-talk" among the viruses will improve the understanding of the pathogenetic mechanism and provide the opportunity to cure this disease.
Bruno
Raffaele
R
Division of infectious and Tropical Diseases, Fondazione IRCCS San Matteo Hospital, University of Pavia, Pavia, Italy. r.bruno@smatteo.pv.it
Sacchi
Paolo
P
Puoti
Massimo
M
Maiocchi
Laura
L
Patruno
Savino Fa
SF
Cima
Serena
S
Filice
Gaetano
G
D016207:Cytokines / Q000276:immunology*; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D015497:HIV-1 / Q000145:classification / Q000235:genetics / Q000472:pathogenicity; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology / Q000276:immunology; D019698:Hepatitis C, Chronic / Q000150:complications / Q000276:immunology; D022781:Hepatocytes / Q000821:virology; D006801:Humans; D008107:Liver Diseases / Q000276:immunology* / Q000821:virology*
D016207:Cytokines