HIV antibodies level as a marker of HIV persistence: the role of hepatitis C virus coinfection

Eur J Clin Microbiol Infect Dis. 2020 Aug;39(8):1503-1512. doi: 10.1007/s10096-020-03875-y. Epub 2020 Mar 31.

Abstract

Human immunodeficiency virus (HIV) antibodies have been proposed as a measure of the size of the HIV reservoir. The aim of our study is to quantify the anti-HIV antibodies level in a cohort of people living with HIV (PLWH), stratified based on the presence of continuous undetectable HIV viral load and the co-existence of hepatitis C virus infection. A sample of 229 HIV-monoinfected (n = 114) or HIV/HCV-coinfected [either with resolved HCV infection (n = 75) or active HCV coinfection (n = 40)] patients, followed up a median of 34 (IQR 20-44) months, was studied. Anti-HIV index was obtained as the 1:800 dilution of HIV antibodies. CD4+ T cell count, time with undetectable HIV viral load, annual increase of CD4+ T cell count, anti-HCV therapy, and diagnosis of cirrhosis were analyzed. Patients with a continued suppressed HIV viral load had significant lower anti-HIV index compared with those with virologic failure during the follow-up. Significant higher CD4+ T cell increase was observed in those with a lower anti-HIV index. HIV-monoinfected patients showed an anti-HIV index significantly lower than patients with HCV coinfection. Resolved HCV infection after interferon-based therapy, but not with direct acting antivirals, was associated with a lower anti-HIV index. HIV/HCV-coinfected patients showed higher HIV antibodies level when compared with HIV-monoinfected individuals. A decrease in anti-HIV index in HIV/HCV-coinfected patients was detected when a sustained virological HCV response was obtained after interferon-based therapy, in possible relation with the direct or indirect effect of interferon on PLWH CD4 T cells.

Keywords: HCV infection; HCV infection treatment; HIV antibodies level; HIV reservoir.

MeSH terms

  • Adult
  • Biomarkers / blood
  • Cohort Studies
  • Coinfection
  • Female
  • HIV Antibodies / blood*
  • HIV Infections / blood
  • HIV Infections / complications
  • HIV Infections / virology*
  • HIV-1 / immunology
  • Hepatitis C, Chronic / blood
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / virology*
  • Humans
  • Male
  • Middle Aged
  • Outpatients
  • Prospective Studies
  • Viral Load

Substances

  • Biomarkers
  • HIV Antibodies