Abstract

Background and AimsHepatitis C Virus (HCV)-related liver disease progresses more rapidly in individuals co-infected with Human Immunodeficiency Virus-1 (HIV), although the underlying immunologic mechanisms are unknown. We examined whether HIV-specific T-cells are identified in the liver of HCV/HIV co-infected individuals and promote liver inflammation through bystander immune responses.Methods Ex-vivo intra-hepatic lymphocytes from HCV mono-infected and HCV/HIV co-infected individuals were assessed for immune responses to HIV and HCV antigens by polychromatic flow cytometry.ResultsHCV/HIV liver biopsies had similar frequencies of lymphocytes but lower percentages of CD4+ T-cells compared to HCV biopsies. In co-infection, intra-hepatic HIV-specific CD8+ and CD4+ T-cells producing IFN-γ and TNF-α were detected and were comparable in frequency to those that were HCV-specific. In co-infected individuals, viral-specific CD8+ T-cells produced more of the fibrogenic cytokine, TNF-α. In both mono- and co-infected individuals, intra-hepatic HCV-specific T-cells were poorly functional compared to HIV-specific T-cells. In co-infection, HAART was not associated with a reconstitution of intra-hepatic CD4+ T-cells and was associated with reduction in both HIV and HCV-specific intra-hepatic cytokine responses.ConclusionThe accumulation of functional HIV-specific T-cells in the liver during HCV/HIV co-infection may represent a bystander role for HIV in inducing faster progression of liver disease.

Highlights

  • 25% of Human Immunodeficiency Virus-1 (HIV) infected individuals are infected with Hepatitis C Virus (HCV) [1]

  • Subject Characteristics Three groups of individuals were studied as depicted in Table 1; HCV mono-infected (n = 6), HCV/HIV co-infected who were not receiving HAART (n = 8) and HCV/HIV co-infected who were receiving HAART for greater than one year at the time of evaluation (n = 12)

  • Characterizing intra-hepatic lymphocytes similar frequencies of intra-hepatic lymphocytes were obtained in dual versus mono-infection, HAART-treated individuals showed a trend towards greater percentages of lymphocytes in their biopsies (Figure 1a)

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Summary

Introduction

25% of Human Immunodeficiency Virus-1 (HIV) infected individuals are infected with Hepatitis C Virus (HCV) [1]. Fewer individuals recover spontaneously from HCV infection when infected with HIV [2]. Among those with persistent HCV infection, HIV co-infection is associated with higher HCV viremia and more rapid progression to cirrhosis and hepatocellular carcinoma [3]. A recent meta-analysis showed that HIV co-infection increased the risk of histological hepatic cirrhosis by two-fold and clinically decompensated liver disease by six-fold [4]. Hepatitis C Virus (HCV)-related liver disease progresses more rapidly in individuals co-infected with Human Immunodeficiency Virus-1 (HIV), the underlying immunologic mechanisms are unknown. We examined whether HIV-specific T-cells are identified in the liver of HCV/HIV co-infected individuals and promote liver inflammation through bystander immune responses

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