Cellular immune responses to HCV core increase and HCV RNA levels decrease during successful antiretroviral therapy

Publication

Cellular immune responses to HCV core increase and HCV RNA levels decrease during successful antiretroviral therapy

Journal Paper/Review - Jul 26, 2010

Rohrbach Janine, Rauch Andri, Klenerman Paul, Furrer Hansjakob, Battegay Manuel, Bernasconi Enos, Hoffmann Matthias, Hirschel Bernhard, Günthard Huldrych F, Keiser Olivia, Telenti Amalio, Gorgievski Meri, Gaudieri Silvana, Hammond Emma, Harcourt Gillian, Robinson Nicola, Swiss HIV Cohort Study SHCS

Units

Division of Infectious Diseases, Infection Prevention and Travel Medicine

Keywords

Antiviral therapy, cellular immunity, Hepatitis C, HIV/AIDS, immune response

Citation

Rohrbach J, Rauch A, Klenerman P, Furrer H, Battegay M, Bernasconi E, Hoffmann M, Hirschel B, Günthard H, Keiser O, Telenti A, Gorgievski M, Gaudieri S, Hammond E, Harcourt G, Robinson N, Swiss HIV Cohort Study S. Cellular immune responses to HCV core increase and HCV RNA levels decrease during successful antiretroviral therapy. Gut 2010; 59:1252-1258.

Type

Journal Paper/Review (English)

Journal

Gut 2010; 59

Publication Date

Jul 26, 2010

Issn Electronic

0017-5749

Pages

1252-1258

Brief description/objective

BACKGROUND: Hepatitis C virus (HCV) infection is a major cause of morbidity in HIV infected individuals. Coinfection with HIV is associated with diminished HCV-specific immune responses and higher HCV RNA levels.

AIMS: To investigate whether long-term combination antiretroviral therapy (cART) restores HCV-specific T cell responses and improves the control of HCV replication.

METHODS: T cell responses were evaluated longitudinally in 80 HIV/HCV coinfected individuals by ex vivo interferon-gamma-ELISpot responses to HCV core peptides, that predominantly stimulate CD4(+) T cells. HCV RNA levels were assessed by real-time PCR in 114 individuals.

RESULTS: The proportion of individuals with detectable T cell responses to HCV core peptides was 19% before starting cART, 24% in the first year on cART and increased significantly to 45% and 49% after 33 and 70 months on cART (p=0.001). HCV-specific immune responses increased in individuals with chronic (+31%) and spontaneously cleared HCV infection (+30%). Median HCV RNA levels before starting cART were 6.5 log(10) IU/ml. During long-term cART, median HCV-RNA levels slightly decreased compared to pre-cART levels (-0.3 log10 IU/ml, p=0.02).

CONCLUSIONS: Successful cART is associated with increasing cellular immune responses to HCV core peptides and with a slight long-term decrease in HCV RNA levels. These findings are in line with the favourable clinical effects of cART on the natural history of hepatitis C and with the current recommendation to start cART earlier in HCV/HIV coinfected individuals.