Preservation of immune function and anti-hepatitis C virus (HCV) immune responses after liver transplantation in HIV-HCV coinfected patients (ANRS-HC08 "THEVIC" trial).
OBJECTIVE
Liver transplantation (LT) in immune-suppressed human immunodeficiency virus (HIV) and hepatitis C virus (HCV) coinfected patients is feasible but raises questions regarding the severity of HCV recurrence on the liver graft and preservation of immune function. We investigated whether LT is deleterious to the immune system.


METHODS
Fourteen HIV-HCV coinfected patients (HIV viral load [VL] <50 copies/ml; median CD4 count of 276/mm(3) pretransplantation) were grafted for HCV-cirrhosis and followed over 2 years. Nine patients received anti-HCV therapy post-transplantation. HCV and HIV VLs and degree of acute and chronic hepatitis were monitored. Peripheral blood T-cell phenotypes and interferon-gamma (IFN-gamma) immune responses against opportunistic pathogens, HCV, and HIV-1 p24 were evaluated.


RESULTS
Median HCV VLs, CD4 counts, T-cell subsets, and IFN-gamma-producing T-cell frequencies against opportunistic pathogens and HIV-1 p24 did not change over time. HCV-specific T cells were observed ex vivo in two patients pretransplantation and in two others post-transplantation. HCV-specific in vitro amplification enabled the detection of HCV-specific IFN-gamma-producing responses in three further patients post-transplantation. Anti-HCV responses were observed independently of anti-HCV therapy and were undetectable in patients with severe hepatitis or liver fibrosis.


CONCLUSIONS
These results demonstrate that LT in HIV-HCV coinfected patients is not deleterious to the immune system and does not alter immune responses directed against HCV, HIV, or opportunistic pathogens.
Samri
Assia
A
Inserm, UMRS-945 Laboratoire d'Immunologie Cellulaire et Tissulaire, Centre Hospitalier Pitié-Salpêtrière, 83 Boulevard de l'hôpital, Bâtiment CERVI, 75013 Paris, France.
Roque-Afonso
Anne-Marie
AM
Beran
Ondrej
O
Tateo
Mariagrazia
M
Teicher
Elina
E
Feray
Cyrille
C
Sebagh
Mylène
M
Guettier
Catherine
C
Dussaix
Elisabeth
E
Vittecoq
Daniel
D
Samuel
Didier
D
Autran
Brigitte
B
Duclos-Vallée
Jean-Charles
JC
D017088:AIDS-Related Opportunistic Infections / Q000276:immunology; D000328:Adult; D018791:CD4 Lymphocyte Count; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000276:immunology / Q000601:surgery; D005260:Female; D016655:HIV Core Protein p24 / Q000276:immunology; D015658:HIV Infections / Q000150:complications* / Q000276:immunology*; D006526:Hepatitis C / Q000150:complications* / Q000276:immunology* / Q000821:virology; D018937:Hepatitis C Antibodies / Q000096:biosynthesis*; D006801:Humans; D007108:Immune Tolerance; D066298:In Vitro Techniques; D007371:Interferon-gamma / Q000096:biosynthesis; D008103:Liver Cirrhosis / Q000209:etiology / Q000276:immunology* / Q000601:surgery*; D008113:Liver Neoplasms / Q000209:etiology / Q000276:immunology / Q000601:surgery; D016031:Liver Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D016176:T-Lymphocyte Subsets / Q000276:immunology; D019562:Viral Load / Q000276:immunology
D016655:HIV Core Protein p24; D018937:Hepatitis C Antibodies; C514799:p24 protein, Human Immunodeficiency Virus Type 1; D007371:Interferon-gamma