title: Immune activation response in chronic HIV-infected patients: influence of Hepatitis C virus coinfection.
abstract: OBJECTIVE
  We have analyzed the parameters (bacterial translocation, immune activation and regulation, presence of HCV coinfection) which could be implicated in an inappropriate immune response from individuals with chronic HIV infection. The influence of them on the evolution of CD4+ T cell count has been investigated.
  
  
  METHODS
  Seventy HIV-infected patients [monoinfected by HIV (n = 20), HCV-coinfected (with (n = 25) and without (n = 25) liver cirrhosis)] and 25 healthy controls were included. Median duration of HIV infection was 20 years. HIV- and HCV-related parameters, as well as markers relative to bacterial translocation, monocyte and lymphocyte activation and regulation were considered as independent variables. Dependent variables were the increase of CD4+ T cell count during the follow-up (12 months).
  
  
  RESULTS
  Increased values of bacterial translocation, measured by lipopolysaccharide-binding protein, monocyte and lymphocyte activation markers and T regulatory lymphocytes were detected in HIV-monoinfected and HIV/HCV coinfected patients. Serum sCD14 and IL-6 were increased in HIV/HCV-coinfected patients with liver cirrhosis in comparison with those with chronic hepatitis or HIV-monoinfected individuals. Time with undetectable HIV load was not related with these parameters. The presence of cirrhosis was negatively associated with a CD4+ T cell count increase.
  
  
  CONCLUSIONS
  In patients with a chronic HIV infection, a persistent increase of lipopolysaccharide-binding protein and monocyte and lymphocyte modifications are present. HCV-related cirrhosis is associated with more elevated serum concentrations of monocyte-derived markers. Cirrhosis influences the continued immune reconstitution of these patients.
authors.affiliation: Servicio de Medicina Interna/Enfermedades Infecciosas, Hospital Universitario Puerta del Mar/Universidad de Cádiz, Cádiz, Spain.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Márquez
authors.affiliation: Servicio de Medicina Interna/Enfermedades Infecciosas, Hospital Universitario Puerta del Mar/Universidad de Cádiz, Cádiz, Spain.
authors.forename: Paula
authors.initials: P
authors.lastname: Romero-Cores
authors.affiliation: Servicio de Medicina Interna/Enfermedades Infecciosas, Hospital Universitario Puerta del Mar/Universidad de Cádiz, Cádiz, Spain.
authors.forename: Monserrat
authors.initials: M
authors.lastname: Montes-Oca
authors.affiliation: Servicio de Medicina Interna/Enfermedades Infecciosas, Hospital Universitario Puerta del Mar/Universidad de Cádiz, Cádiz, Spain.
authors.forename: Andrés
authors.initials: A
authors.lastname: Martín-Aspas
authors.affiliation: Servicio de Medicina Interna/Enfermedades Infecciosas, Hospital Universitario Puerta del Mar/Universidad de Cádiz, Cádiz, Spain.
authors.forename: María-José
authors.initials: MJ
authors.lastname: Soto-Cárdenas
authors.affiliation: Servicio de Medicina Interna/Enfermedades Infecciosas, Hospital Universitario Puerta del Mar/Universidad de Cádiz, Cádiz, Spain.
authors.forename: Francisca
authors.initials: F
authors.lastname: Guerrero
authors.affiliation: Servicio de Microbiología, Hospital Universitario Puerta del Mar/Universidad de Cádiz, Cádiz, Spain.
authors.forename: Clotilde
authors.initials: C
authors.lastname: Fernández-Gutiérrez
authors.affiliation: Servicio de Medicina Interna/Enfermedades Infecciosas, Hospital Universitario Puerta del Mar/Universidad de Cádiz, Cádiz, Spain.
authors.forename: José-Antonio
authors.initials: JA
authors.lastname: Girón-González
mesh_terms: D000328:Adult; D018988:Bacterial Translocation; D018791:CD4 Lymphocyte Count; D060085:Coinfection / Q000276:immunology* / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology* / Q000382:microbiology; D006526:Hepatitis C / Q000150:complications / Q000276:immunology*; D006801:Humans; D007110:Immunity, Active; D008103:Liver Cirrhosis / Q000276:immunology* / Q000821:virology; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies