title: CD4 and CD4/CD8 ratio progression in HIV-HCV infected patients after achievement of SVR.
abstract: In HIV-HCV co-infected patients, the long-term effects of HCV eradication on HIV disease progression are still unclear.
  
  
  
  This study aims to determine if CD4 and CD4/CD8 ratio slopes improved after anti-HCV treatment in patients achieving a sustained virological response (SVR).
  
  
  
  A total of 116 HIV-HCV co-infected patients, previously treated with Peg-IFN/RBV, were divided into two groups: SVR (55 patients who had achieved SVR), and non-SVR (61 patients). Retrospective data before and after anti-HCV therapy were obtained for all patients, with a median 8 year-follow-up. Multilevel mixed models were fitted to assess the trends over time of FIB-4 score, APRI score, CD4, CD8 cell count and CD4/CD8 ratio.
  
  
  
  Median HIV-infection duration, HCV-RNA and GGT baseline levels were higher in non-SVR compared to the SVR group. A significantly decreased FIB-4 (p<0.001) and APRI trend (p<0.001) after SVR was observed in SVR patients compared to those non-SVR. After adjustment for HIV duration, there was no significant difference between the two groups for absolute CD4 (p=0.08) or percentage CD4 slope (p=0.6) over time. The CD4/CD8 ratio trend also demonstrated a similar progressive increase in both groups (p=0.2). During follow-up, six deaths were reported in the non-SVR group versus no death for the SVR group, while no difference in AIDS and non-AIDS events was observed.
  
  
  
  Achievement of SVR determines an important beneficial impact in terms of liver-related mortality and fibrosis regression, but does not seem to alter neither the slope of long term CD4 gain nor the CD4/CD8 ratio evolution in ART-treated HIV-HCV co-infected patients.
authors.affiliation: Clinic of Infectious Diseases, University of Bari, Italy. Electronic address: annalisa.saracino@uniba.it.
authors.forename: A
authors.initials: A
authors.lastname: Saracino
authors.affiliation: Clinic of Infectious Diseases, University of Bari, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Bruno
authors.affiliation: Scientific Direction, Clinical Epidemiology Unit, IRCCS San Matteo Foundation, Pavia, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Scudeller
authors.affiliation: Clinic of Infectious Diseases, University of Bari, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Ladisa
authors.affiliation: Clinic of Infectious Diseases, University of Bari, Italy.
authors.forename: N
authors.initials: N
authors.lastname: de Gennaro
authors.affiliation: Clinic of Infectious Diseases, University of Bari, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Allegrini
authors.affiliation: Clinic of Infectious Diseases, University of Bari, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Monno
authors.affiliation: Clinic of Infectious Diseases, University of Bari, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Angarano
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D016516:CD4-CD8 Ratio; D060085:Coinfection / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology / Q000821:virology; D019698:Hepatitis C, Chronic / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology / Q000821:virology; D006801:Humans; D008103:Liver Cirrhosis; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000072230:Sustained Virologic Response; D055815:Young Adult
chemical_list: D000998:Antiviral Agents
keywords: APRI; CD4; CD4/CD8 ratio; FIB-4; HIV-HCV co-infection; Liver fibrosis; SVR