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

Rohrbach, Janine
Robinson, Nicola
Harcourt, Gillian
Hammond, Emma
Gaudieri, Silvana
Gorgievski, Meri
Telenti, Amalio
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Published in Gut. 2010, vol. 59, no. 9, p. 1252-1258
Abstract 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.
Keywords AdultAnti-HIV Agents/*therapeutic useAntiretroviral Therapy, Highly ActiveCD4 Lymphocyte CountCohort StudiesFemaleHIV Infections/complications/drug therapy/immunologyHepacivirus/drug effects/genetics/*immunology/isolation & purificationHepatitis C Antigens/immunologyHepatitis C, Chronic/complications/drug therapy/*immunologyHumansImmunity, Cellular/drug effectsInterferon-gamma/biosynthesisLongitudinal StudiesMaleRNA, Viral/bloodT-Lymphocytes/drug effects/immunologyViral Core Proteins/immunologyViral Load/drug effects
PMID: 20660698
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Other version: http://gut.bmj.com/content/59/9/1252.full.pdf
Research group Unité HIV (46)
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ROHRBACH, Janine et al. Cellular immune responses to HCV core increase and HCV RNA levels decrease during successful antiretroviral therapy. In: Gut, 2010, vol. 59, n° 9, p. 1252-1258. doi: 10.1136/gut.2009.205971 https://archive-ouverte.unige.ch/unige:21263

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Deposited on : 2012-05-23

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