title: Impact of hepatitis C virus coinfection on T-cell dynamics in long-term HIV-suppressors under combined antiretroviral therapy.
abstract: OBJECTIVE
  The objective of this study is to evaluate the impact of hepatitis C virus (HCV) serostatus on the evolution of CD8 cells and CD4 : CD8 ratio in HIV-infected patients on combined antiretroviral therapy (cART) who achieve sustained undetectable viral load (HIV-pVL).
  
  
  METHODS
  A longitudinal study performed in an outpatient HIV-unit following 1495 HIV-infected patients. Data of patients on cART achieving undetectable HIV-pVL for at least 3 years were collected retrospectively from our medical e-database NADIS from January 1997 to April 2005, a period defined in order to select patients who were naive of hepatitis treatment. T-cell counts were assessed every 6 months from HIV-suppression over the study period.
  
  
  RESULTS
  Two hundred and twenty-six HIV mono-infected (group 1) and 130 HCV-coinfected patients (group 2; genotype prevalence: 42% HCV-G1, 26% HCV-G3, 11% HCV-G4 and 21% HCV-G2) fulfilled the selection criteria. cART regimens were comparable between the groups, as were CD4 and CD8 cell counts at the first undetectable HIV-pVL. After 3 years, both groups displayed similar CD4 cell reconstitution, although CD4 percentage was higher in group 1 (30.3 ± 1.1 vs. 27 ± 1.1%; P < 0.001). HIV suppression led to a significant drop of median CD8 cell counts in group 1 (P = 0.027), but not in group 2, which displayed higher CD8 cell counts all through the follow-up (mean diff. = 135.71 ± 26.89 cells/μl, P < 0.001). Moreover, the fraction of patients reaching CD4 : CD8 ratio ≥ 1 was lower in group 2 (14 vs. 27.7%; P < 0.05).
  
  
  CONCLUSIONS
  Despite sustained HIV suppression under cART, HCV coinfection was found to hamper CD8 downregulation. Further studies will determine the impact of treatment with direct-acting antiviral agents on the CD8 pool, and the advantage of systematic HCV-targeted therapy for HIV/HCV-coinfected patients.
authors.affiliation: aAix-Marseille University, APHM-Sainte Marguerite Hospital, Immunohematology Clinical Unit/HIV Clinical Center bAix-Marseille University, APHM-Conception Hospital, Service d'hématologie et de biologie vasculaire cAix-Marseille University, APHM-Timone Hospital, Fédération de Microbiologie Hospitalière dURMITE CNRS-IRDUMR6236 eInserm U912 (SESSTIM), Marseille, France.
authors.forename: Olivia
authors.initials: O
authors.lastname: Zaegel-Faucher
authors.forename: Sylvie
authors.initials: S
authors.lastname: Bregigeon
authors.forename: Carla Eliana
authors.initials: CE
authors.lastname: Cano
authors.forename: Véronique
authors.initials: V
authors.lastname: Obry-Roguet
authors.forename: Corinne
authors.initials: C
authors.lastname: Nicolino-Brunet
authors.forename: Catherine
authors.initials: C
authors.lastname: Tamalet
authors.forename: Françoise
authors.initials: F
authors.lastname: Dignat-George
authors.forename: Isabelle
authors.initials: I
authors.lastname: Poizot-Martin
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D016516:CD4-CD8 Ratio; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D060085:Coinfection / Q000276:immunology*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000276:immunology*; D020276:HIV Long-Term Survivors; D019698:Hepatitis C, Chronic / Q000150:complications / Q000276:immunology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D019562:Viral Load
chemical_list: D044966:Anti-Retroviral Agents