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Basso M, Zago D, Scaggiante R, Cavinato S, Pozzetto I, Stagni C, Parisatto B, Cattelan AM, Battagin G, Sarmati L, Parisi SG. HIV tropism switch in archived DNA of HIV-HCV subjects successfully treated with direct-acting antivirals for HCV infection. Sci Rep 2021; 11:9274. [PMID: 33927306 PMCID: PMC8085114 DOI: 10.1038/s41598-021-88811-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 04/16/2021] [Indexed: 02/02/2023] Open
Abstract
We described short-term HIV tropism changes occurring in peripheral blood mononuclear cells and the correlations with HIV DNA value in HIV-HCV co-infected patients cured for HCV disease and with undetectable HIV viremia or residual viremia (RV). Plasma HIV RNA, cellular HIV DNA and tropism were evaluated pre-HCV treatment (baseline, BL) and at 12(T1) and 24(T2) weeks after HCV treatment start. V3 sequences were interpreted using Geno2pheno and classified as R5 only if all three sequences had an FPR ≥ 10% and as X4 when at least one replicate sequence had an FPR < 10%. Forty-nine patients (21 with X4 and 28 with R5 virus) were enrolled. Five X4 patients and 9 R5 subjects experienced at least one tropism change,11 with RV:1/5 patients with X4 infection at BL switched at T1 versus 8/9 in the R5 group (p = 0.022977) and the difference was confirmed in subjects with RV (p = 0.02);6/9 R5 patients switching at T1 confirmed the tropism change at T2. No significant differences in HIV DNA values between patients with RV starting with a R5 or X4 tropism and experienced tropism switch or not were found. Short-term tropism switch involved almost a third of patients, in all but three cases with HIV RV. Being R5 at BL is associated to a higher instability, expressed as number of tropism changes and confirmed switch at T2.
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Affiliation(s)
- Monica Basso
- grid.5608.b0000 0004 1757 3470Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padua, Italy
| | - Daniela Zago
- grid.5608.b0000 0004 1757 3470Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padua, Italy
| | | | - Silvia Cavinato
- grid.411474.30000 0004 1760 2630Infectious Diseases Unit, Azienda Ospedaliera-Universitaria di Padova, Padua, Italy
| | - Irene Pozzetto
- grid.5608.b0000 0004 1757 3470Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padua, Italy
| | - Camilla Stagni
- grid.5608.b0000 0004 1757 3470Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padua, Italy
| | - Beatrice Parisatto
- grid.5608.b0000 0004 1757 3470Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padua, Italy
| | - Anna Maria Cattelan
- grid.411474.30000 0004 1760 2630Infectious Diseases Unit, Azienda Ospedaliera-Universitaria di Padova, Padua, Italy
| | | | - Loredana Sarmati
- grid.6530.00000 0001 2300 0941Infectious Diseases Clinic, Università Tor Vergata, Rome, Italy
| | - Saverio Giuseppe Parisi
- grid.5608.b0000 0004 1757 3470Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padua, Italy
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Restrepo C, Álvarez B, Valencia JL, García M, Navarrete-Muñoz MA, Ligos JM, Cabello A, Prieto L, Nistal S, Montoya M, Górgolas M, Rallón N, Benito JM. Both HCV Infection and Elevated Liver Stiffness Significantly Impacts on Several Parameters of T-Cells Homeostasis in HIV-Infected Patients. J Clin Med 2020; 9:jcm9092978. [PMID: 32942736 PMCID: PMC7564456 DOI: 10.3390/jcm9092978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 09/11/2020] [Indexed: 11/16/2022] Open
Abstract
(1) Background: The role of hepatitis C virus (HCV) co-infection on the T-cell homeostasis disturbances in human immunodeficiency virus (HIV)-infected patients as well as its reversion after HCV eradication with direct acting antivirals (DAAs) therapy has not been yet clarified. We extensively analyzed the effect of HCV co-infection on immune parameters of HIV pathogenesis and its evolution after HCV eradication with DAAs. (2) Methods: Seventy individuals were included in the study-25 HIV-monoinfected patients, 25 HIV/HCV-coinfected patients and 20 HIV and HCV seronegative subjects. All patients were on antiretroviral therapy and undetectable HIV-viremia. Immune parameters, such as maturation, activation, apoptosis, senescence and exhaustion of T-cells were assessed by flow cytometry. Cross-sectional and longitudinal (comparing pre- and post-DAAs data in HIV/HCV coinfected patients) analyses were performed. Univariate and multivariate (general linear model and canonical discriminant analysis -CDA-) analyses were used to assess differences between groups. (3) Results-The CDA was able to clearly separate HIV/HCV coinfected from HIV-monoinfected patients, showing a more disturbed T-cells homeostasis in HIV/HCV patients, especially activation and exhaustion of T-cells. Interestingly, those perturbations were more marked in HIV/HCV patients with increased liver stiffness. Eradication of HCV with DAAs restored some but not all the T-cells homeostasis disturbances, with activation and exhaustion of effector CD8 T-cells remaining significantly increased three months after HCV eradication. (4) Conclusions-HCV co-infection significantly impacts on several immune markers of HIV pathogenesis, especially in patients with increased liver stiffness. Eradication of HCV with DAAs ameliorates but does not completely normalize these alterations. It is of utmost relevance to explore other mechanisms underlying the immune damage observed in HIV/HCV coinfected patients with control of both HIV and HCV replication.
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Affiliation(s)
- Clara Restrepo
- HIV and Viral Hepatitis Research Laboratory, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Universidad Autónoma de Madrid (IIS-FJD, UAM), 28933 Madrid, Spain; (C.R.); (M.G.); (M.A.N.-M.); (J.M.B.)
- Hospital Universitario Rey Juan Carlos, Móstoles, 28933 Madrid, Spain;
| | - Beatriz Álvarez
- Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain; (B.Á.); (A.C.); (L.P.); (M.G.)
| | - José L Valencia
- Departamento de Estadística e Investigación Operativa III, Facultad de Estudios Estadísticos, Universidad Complutense de Madrid, 28040 Madrid, Spain;
| | - Marcial García
- HIV and Viral Hepatitis Research Laboratory, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Universidad Autónoma de Madrid (IIS-FJD, UAM), 28933 Madrid, Spain; (C.R.); (M.G.); (M.A.N.-M.); (J.M.B.)
- Hospital Universitario Rey Juan Carlos, Móstoles, 28933 Madrid, Spain;
| | - María A Navarrete-Muñoz
- HIV and Viral Hepatitis Research Laboratory, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Universidad Autónoma de Madrid (IIS-FJD, UAM), 28933 Madrid, Spain; (C.R.); (M.G.); (M.A.N.-M.); (J.M.B.)
- Hospital Universitario Rey Juan Carlos, Móstoles, 28933 Madrid, Spain;
| | - José M Ligos
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), 28029 Madrid, Spain; (J.M.L.); (M.M.)
| | - Alfonso Cabello
- Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain; (B.Á.); (A.C.); (L.P.); (M.G.)
| | - Laura Prieto
- Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain; (B.Á.); (A.C.); (L.P.); (M.G.)
| | - Sara Nistal
- Hospital Universitario Rey Juan Carlos, Móstoles, 28933 Madrid, Spain;
| | - María Montoya
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), 28029 Madrid, Spain; (J.M.L.); (M.M.)
| | - Miguel Górgolas
- Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain; (B.Á.); (A.C.); (L.P.); (M.G.)
| | - Norma Rallón
- HIV and Viral Hepatitis Research Laboratory, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Universidad Autónoma de Madrid (IIS-FJD, UAM), 28933 Madrid, Spain; (C.R.); (M.G.); (M.A.N.-M.); (J.M.B.)
- Hospital Universitario Rey Juan Carlos, Móstoles, 28933 Madrid, Spain;
- Correspondence: ; Tel.: +34-91-544-37-20; Fax: +34-91-550-48-49
| | - José M Benito
- HIV and Viral Hepatitis Research Laboratory, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Universidad Autónoma de Madrid (IIS-FJD, UAM), 28933 Madrid, Spain; (C.R.); (M.G.); (M.A.N.-M.); (J.M.B.)
- Hospital Universitario Rey Juan Carlos, Móstoles, 28933 Madrid, Spain;
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Abstract
Thymus glands from 283 autopsy cases were sampled and evaluated with histochemical and immunohistochemical methods. A subpopulation of 41 intravenous drug addicts were compared with age-matched control cases.It was found that an accelerated involution of the thymus occurred in the 20- to 25-year interval and thereafter with a steady pace of 5% per year. Also the size of Hassall bodies declined successively.In drug addicts, an increased dystrophic calcification of the Hassall bodies and a significant difference in thymus size (atrophy) compared with controls were seen. Moreover, a difference was seen in the relative numbers of CD4 and CD8 lymphocytes where CD4+ cells were reduced in drug addicts.It is hypothesized that signs of hepatitis C virus infection that was found in the majority of drug addicts and the reduced number of functionally intact Hassall corpuscles could explain the reduction of CD4+ lymphocytes and thymic hypotrophy in this population.
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Ledipasvir-Sofosbuvir for 8 Weeks in Non-Cirrhotic Patients with Previously Untreated Genotype 1 HCV Infection ± HIV-1 Co-Infection. Clin Drug Investig 2018; 38:239-247. [PMID: 29177645 DOI: 10.1007/s40261-017-0606-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND OBJECTIVES: The efficacy of < 12 weeks of hepatitis C virus (HCV) treatment in patients co-infected with HCV and human immunodeficiency virus type 1 (HIV-1) has not been established. We assessed the efficacy and safety of ledipasvir-sofosbuvir for 8 weeks in HCV mono-infected and HCV/HIV-1 co-infected patients. METHODS We enrolled patients mono-infected with genotype 1 HCV or co-infected with HCV and HIV-1 who were HCV treatment-naive and did not have cirrhosis. HCV/HIV-1 co-infected patients were either not receiving antiretroviral treatment and had a CD4 T-cell count > 500 cells/mm3 or were receiving a protocol-approved antiretroviral regimen for ≥ 8 weeks (or ≥ 6 months for abacavir-containing regimens) and had HIV-1 RNA < 50 copies/mL and a CD4 T-cell count > 200 cells/mm3. Patients received ledipasvir-sofosbuvir (90/400 mg) once daily for 8 weeks. The primary efficacy endpoint was sustained virologic response 12 weeks after treatment discontinuation (SVR12). RESULTS The SVR12 rate was 100% (67/67) for HCV mono-infected patients and 97% (57/59) for HCV/HIV-1 co-infected patients. Two patients relapsed by the week 4 post-treatment visit. Overall, the most common adverse events were headache (52%) and upper abdominal pain (26%). There were no serious adverse events or treatment discontinuations due to adverse events. No HCV/HIV-1 co-infected patients receiving antiretroviral treatment experienced HIV virologic rebound, and no clinically meaningful changes in CD4 T-cell counts were observed in any co-infected patient. CONCLUSIONS Non-cirrhotic, treatment-naive patients with genotype 1 HCV mono-infection and HCV/HIV-1 co-infection achieved high rates of SVR12 with 8 weeks of treatment with ledipasvir/sofosbuvir. ClinicalTrials.gov identifier: NCT02472886.
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