Impact of HBV and HCV coinfection on CD4 cells among HIV-infected patients: a longitudinal retrospective study

Claudinei Mesquita Da Silva,Omar Cleo Neves Pereira,Isolde Previdelli,Eraldo S Silva,Dennis Armando Bertolini,Jorge Juarez Vieira Teixeira,Leyde Daiane De Peder

doi:10.3855/jidc.10035

Claudinei Mesquita Da Silva, Omar Cleo Neves Pereira + Show 5 more

Open Access

https://doi.org/10.3855/jidc.10035

Copy DOI

Abstract

The impact of hepatitis B virus (HBV) and hepatitis C virus (HCV) coinfection on CD4 cells in patients with human immunodeficiency virus (HIV) is unclear. We aimed to examine the impact of HBV and HCV coinfection on CD4 cell count and CD4/CD8 ratio in adults with HIV. We conducted a longitudinal retrospective study in Brazil between January 1, 2002, and June 30, 2016, including 205 patients with HIV monoinfection, 37 with HIV-HBV coinfection, 35 with HIV-HCV coinfection, and 62 with HIV-HCV (48 HCV genotype 1 and 14 HCV genotype 3). Median duration of follow-up was 2,327 (interquartile range: 1,159-3,319) days. An increased CD4 cell count and CD4/CD8 ratio over time was observed in all groups receiving combined antiretroviral therapy (cART). Patients with HIV-HBV or HIV-HCV coinfection and those with HIV monoinfection, showed comparable CD4 cell counts and CD4/CD8 ratios during pre-ART. There was also no statistically significant difference in CD4/CD8 ratio between HIV-HBV or HIV-HCV coinfection groups and the HIV monoinfection group during follow-up on cART. However, CD4 cell counts were significantly lower in HIV-HCV patients than in HIV monoinfection patients during follow-up on cART. HIV patients with HCV genotype 3 coinfection showed significantly lower CD4/CD8 ratio during follow-up on cART than those coinfected with HCV genotype 1 coinfection. No statistically significant effect of coinfection was observed on the efficacy of cART. HIV-infected patients are more likely to show better immunological responses to cART when they are not coinfected with HCV.

Highlights

The impact of hepatitis B virus (HBV) and hepatitis C virus (HCV) coinfection on CD4 cells in patients with human immunodeficiency virus (HIV) is unclear
Of all HIV-infected patients diagnosed in the study period, 6.46% (205/3,174) of those with HIV monoinfection, 59.68% (37/62) of those with HIVHBV coinfection, 36.08% (35/97) of those with HIVHCV, and 63.91% (62/97) of those with HCV genotypes 1 and 3 among HIV-coinfected patients met the inclusion criteria for the longitudinal retrospective study
The present study showed a lack of statistically significant difference between HCV genotypes 1 and 3 among HIV-infected patients for the CD4 cell count in pre-ART and during follow-up on combined antiretroviral therapy (cART); these data are supported by the literature [43,44]

Summary

Introduction

The impact of hepatitis B virus (HBV) and hepatitis C virus (HCV) coinfection on CD4 cells in patients with human immunodeficiency virus (HIV) is unclear. Patients with HIV-HBV or HIV-HCV coinfection and those with HIV monoinfection, showed comparable CD4 cell counts and CD4/CD8 ratios during pre-ART. There was no statistically significant difference in CD4/CD8 ratio between HIV-HBV or HIV-HCV coinfection groups and the HIV monoinfection group during followup on cART. CD4 cell counts were significantly lower in HIV-HCV patients than in HIV monoinfection patients during follow-up on cART. It has been estimated that 36.7 million people worldwide are living with HIV infection [1], 257 million people with chronic HBV infection, and 71 million people with HCV infection [2] These viruses share common routes of transmission and many people with HIV are coinfected with HBV and/or HCV [3,4]. HIV, HBV, and HCV coinfections have become public health concerns

Objectives

Methods

Results

Discussion

Conclusion