Transient Liver Injury Associated With the Early Recovery of HCV-Specific T-Cell Responses and HCV Rebound in HIV-1/HCV Coinfected Patients Undergoing Highly Active Antiretroviral Therapy

1The Treatment and Research Center for Infectious Diseases, Beijing 302 Hospital, Beijing 100039, China 2Research Center of Biological Therapy, Beijing 302 Hospital, Beijing 100039, China.
JAIDS Journal of Acquired Immune Deficiency Syndromes (Impact Factor: 4.39). 10/2012; 62(2). DOI: 10.1097/QAI.0b013e3182752d20
Source: PubMed

ABSTRACT OBJECTIVES:: HIV-1/HCV co-infection accelerates the progression of liver disease to cirrhosis, particularly in individuals with low CD4 T cell counts. Highly active antiretroviral therapy (HAART) can significantly increase HCV-specific T cell responses; however, it remains unclear whether the restoration of HCV-specific T cells by HAART is associated with liver injury in these co-infection patients. METHODS:: A total of 32 HIV-1/HCV co-infected patients and 14 HCV mono-infected patients were enrolled, and 13 co-infected patients were initialized HAART and followed-up for 6 months. HCV-specific interferon-γ responses to HCV core and NS3A proteins were examined by enzyme-linked immunosorbent spot. RESULTS:: HCV-specific interferon-γ responses to HCV core and NS3A proteins were impaired in HIV-1/HCV co-infected patients as compared with those in HCV mono-infected patients. The impaired HCV-specific T cell responses could be efficiently restored during the early phase of HAART, independent of HCV status, and were positively associated with increased CD4 T cell counts. In addition, this recovery of HCV-specific T cell responses occurred simultaneously with elevated serum ALT levels in HCV viremic patients and in patients with HCV rebound, but not in HCV non-viremic patients after 6 months of HAART. CONCLUSION:: The recovery of HCV-specific T cell responses by HAART may lead to transient liver injury in patients with HIV-1/HCV co-infection, suggesting that early anti-HCV therapy before HAART may reduce the risk of liver injury and therefore may be beneficial to HIV-1/HCV co-infected patients.

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