title: Coinfection with HIV-1 alleviates iron accumulation in patients with chronic hepatitis C virus infection.
abstract: Most chronically-infected hepatitis C virus (HCV) patients have increased levels of iron in the liver. Iron overload reduces sustained responses to antiviral therapy, leading to more rapid progression to liver cirrhosis and the development of hepatocellular carcinoma. However, it is still unclear how HIV-1 infection affects iron status in patients chronically infected with HCV. The present study recruited 227 patients from a village in central China. These patients were either monoinfected with HCV (n = 129) or coinfected with HCV/HIV-1 (n = 98). Healthy controls (n = 84) were also recruited from the same village. Indicators of iron status, such as serum levels of iron, ferritin, and transferrin, total iron-binding capacity (TIBC), transferrin saturation (Tfs), and hepcidin, were analyzed and compared across the three groups. The results showed that serum levels of iron (p = 0.001) and ferritin (p = 0.009) and the Tfs (p = 0.002) were significantly higher in HCV-monoinfected patients than in the healthy controls; however, there were no differences in iron levels and Tfs between HCV/HIV-1 coinfected patients and healthy controls. Additionally, although serum hepcidin levels in HCV-monoinfected and HCV/HIV-1-coinfected patients were lower (p<0.001) than those in health controls, the levels in coinfected patients were higher (p = 0.025) than those in HCV-monoinfected patients. Serum iron and ferritin levels in HCV-monoinfected patients were positively correlated with serum ALT/AST. Serum transferrin levels were negatively correlated with ALT/AST levels. The levels of iron in the serum of coinfected patients with a CD4+T-cell count <500/µl were lower than those in patients with a CD4+T-cell count ≥500/µl, whereas serum hepcidin levels showed the opposite trend. Taken together, these results suggest that coinfection with HIV-1 alleviates iron accumulation caused by chronic HCV infection. Our study indicated that determining the status of serum iron and other iron-associated parameters will be helpful to understand the complexity of alternations in iron distribution in HCV/HIV-1-coinfected patients.
authors.affiliation: Department of Microbiology & Infectious Disease Center, Peking University Health Science Center, Beijing, China; Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Henan, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Henan, China.
authors.forename: Quanjun
authors.initials: Q
authors.lastname: Lv
authors.affiliation: Department of Microbiology & Infectious Disease Center, Peking University Health Science Center, Beijing, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Gao
authors.affiliation: Department of Microbiology & Infectious Disease Center, Peking University Health Science Center, Beijing, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Long
authors.affiliation: Department of Microbiology & Infectious Disease Center, Peking University Health Science Center, Beijing, China.
authors.forename: Zhaojun
authors.initials: Z
authors.lastname: Duan
authors.affiliation: State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Liang
authors.affiliation: Department of Microbiology & Infectious Disease Center, Peking University Health Science Center, Beijing, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Shen
authors.affiliation: Department of Microbiology & Infectious Disease Center, Peking University Health Science Center, Beijing, China.
authors.forename: Fengmin
authors.initials: F
authors.lastname: Lu
mesh_terms: D000328:Adult; D002681:China; D060085:Coinfection; D005260:Female; D006678:HIV / Q000276:immunology; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000821:virology*; D016174:Hepacivirus / Q000276:immunology; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications* / Q000821:virology*; D064451:Hepcidins / Q000097:blood; D006801:Humans; D007501:Iron / Q000097:blood*; D033862:Iron-Binding Proteins / Q000097:blood; D008297:Male; D008875:Middle Aged
chemical_list: D064451:Hepcidins; D033862:Iron-Binding Proteins; D007501:Iron