title: Antibody and markers of T-cell activation illuminate the pathogenesis of HCV immune restoration disease in HIV/HCV co-infected patients commencing ART.
abstract: Some HIV/hepatitis C virus co-infected patients beginning ART experience Immune Restoration Disease (IRD) manifested as a rise in serum alanine transaminase. This was investigated in HIV/HCV co-infected individuals (n=50) commencing ART in Jakarta (Indonesia). Samples were collected at weeks 0, 4, 8, 12, 24 and at HCV IRD. Nine patients experienced HCV IRD (incidence=9.2 per 1000 person-weeks). These resolved without changing treatment. Markers of T-cell activation (sCD26, sCD30) and immune recruitment (CXCL10) increased in many HCV IRD cases, so T-cells may mediate HCV IRD. Total anti-HCV antibody (core, NS3, NS4) remained lower in HCV IRD cases, but levels of antibody to core were not lower in HCV IRD cases. Rises in HCV RNA on ART were independent of HCV IRD, but there was a negative correlation between baseline HCV RNA and total anti-HCV antibody. High levels of antibody may protect against HCV IRD, via lower HCV antigen loads.
authors.affiliation: School of Medicine, University of Indonesia/Cipto Mangunkusomo Hospital, Jakarta, Indonesia.
authors.forename: Evy
authors.initials: E
authors.lastname: Yunihastuti
authors.forename: Silvia
authors.initials: S
authors.lastname: Lee
authors.forename: Rino A
authors.initials: RA
authors.lastname: Gani
authors.forename: Henny
authors.initials: H
authors.lastname: Saraswati
authors.forename: Heru
authors.initials: H
authors.lastname: Sundaru
authors.forename: L A
authors.initials: LA
authors.lastname: Lesmana
authors.forename: Nanang
authors.initials: N
authors.lastname: Sukmana
authors.forename: Patricia
authors.initials: P
authors.lastname: Price
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D015415:Biomarkers; D005260:Female; D015658:HIV Infections / Q000150:complications*; D016174:Hepacivirus / Q000276:immunology; D006526:Hepatitis C / Q000150:complications*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000276:immunology / Q000378:metabolism*; D008213:Lymphocyte Activation / Q000502:physiology*; D008297:Male; D012367:RNA, Viral / Q000097:blood; D013601:T-Lymphocytes / Q000502:physiology*
chemical_list: D019380:Anti-HIV Agents; D015415:Biomarkers; D018937:Hepatitis C Antibodies; D012367:RNA, Viral