Abstract
BackgroundLittle is known about HBV-specific T-cell responses in chronic Hepatitis B patients (HBV) that are co-infected with Human immunodeficiency virus type 1 (HIV-1), especially those with normal alanine aminotransferase (ALT) levels.MethodsTwenty-five patients with chronic HBV (11 hepatitis B e antigen [HBeAg]-positive, 14 HBeAg-negative) were enrolled in a cross-sectional study. A longitudinal study as also conducted in which follow-up was done at 3, 12, and 24 months, after acute HIV-1 infection, in 11 individuals who also had chronic HBV. Peripheral blood mononuclear cells were stimulated with recombinant HBV surface protein (S protein), core protein (C protein) or gag peptide. IFN-γ-secreting T cells were identified by ELISPOT assay.ResultsIn the cross-sectional study, co-infected chronic HBV patients had lower C protein-specific T-cell responses compared with mono-infected individuals, though the difference was not significant. In co-infected, chronic HBV patients, the magnitude of C protein-specific T-cell responses was significantly greater in HBeAg-positive subjects compared to HBeAg-negative subjects (p = 0.011). C protein-specific T-cell responses were positively correlated with HBV viral load (rs = 0.40, p = 0.046). However, gag-specific T-cell responses were negatively correlated with HIV viral load (rs = −0.44, p = 0.026) and positively correlated with CD4+ count (rs = 0.46, p = 0.021). The results were different in mono-infected individuals. PBMCs from co-infected HBeAg-positive patients secreted more specific-IFN-γ in cultured supernatants compared with PBMCs from co-infected HBeAg-negative patients (p = 0.019). In the longitudinal study, S protein- and C protein-specific T-cell responses were decreased as the length of follow-up increased (p = 0.034, for S protein; p = 0.105, for C protein). Additionally, the S protein- and C protein-specific T-cell responses were significantly higher in HBeAg-positive patients than in HBeAg-negative patients at 3 and 12 months after HIV-1 infection (all p < 0.05), but not at 24 months. A positive correlation (trend) was found between C protein-specific T-cell responses and HBV viral load at 3 and 12 months after HIV-1 infection.ConclusionsHBV-specific T-cell responses to recombinant HBV core protein were reduced in chronic HBV patients co-infected with HIV-1. The reduced C protein-specific T cell responses were positively correlated with HBV viral load in co-infected, chronic HBV patients.
Highlights
Little is known about Hepatitis B virus (HBV)-specific T-cell responses in chronic Hepatitis B patients (HBV) that are coinfected with Human immunodeficiency virus type 1 (HIV-1), especially those with normal alanine aminotransferase (ALT) levels
HBV individuals that are coinfected with HIV seroconvert from hepatitis B precore antigen (HBeAg) to anti-HBeAg antibody (HBeAb) less frequently, have higher HBV DNA levels, lower levels of alanine aminotransferase (ALT) and a history of milder necroinflammatory activity, compared to those infected with HBV only [1,2,3,4]
We examined whether HBV-specific T-cell responses in chronic HBV patients could be influenced by the presence or absence of HBeAg or by the level of HBV DNA, in the presence of HIV-1
Summary
Little is known about HBV-specific T-cell responses in chronic Hepatitis B patients (HBV) that are coinfected with Human immunodeficiency virus type 1 (HIV-1), especially those with normal alanine aminotransferase (ALT) levels. Patients with Human immunodeficiency virus type 1 (HIV-1) are frequently found to be co-infected with Hepatitis B virus (HBV). These patients often have a high prevalence of hepatitis B surface antigen (HBsAg)or hepatitis B core antibody (HBcAb)-positive HBV serological markers due to common infection routes. HBV individuals that are coinfected with HIV seroconvert from hepatitis B precore antigen (HBeAg) to anti-HBeAg antibody (HBeAb) less frequently, have higher HBV DNA levels, lower levels of alanine aminotransferase (ALT) and a history of milder necroinflammatory activity, compared to those infected with HBV only [1,2,3,4]. Determining the pathogenesis associated with HIV-1 and HBV interaction, including the modification of the immune responses, will allow for the development of a rational approach for the management of coinfected individuals
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