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Shikuma CM, Le T, Phuong TV, Chew GM, Nguyen VVC, Vo TL, Siriwardhana C, Chow D, Ghukasyan H, Limpruttidham N, Premeaux T, Gangcuangco LM, Paul R, Ndhlovu LC. Immunologic Change over 72 Weeks Following Raltegravir- Versus Efavirenz-Based Therapy in HIV/HCV-Coinfected Individuals in Vietnam. AIDS Res Hum Retroviruses 2022; 38:441-450. [PMID: 34861767 PMCID: PMC10027344 DOI: 10.1089/aid.2021.0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The impact of HIV antiretroviral therapy (ART) on immune dysregulation associated with hepatitis C virus (HCV)/HIV coinfection is incompletely understood. We serially assessed monocyte activation (neopterin, sCD14, and sCD163) and T cell activation (HLA-DR, CD38) and immune exhaustion [program cell death protein 1 (PD1), TIGIT] in HIV/HCV-coinfected individuals who participated in a randomized trial performed in Vietnam designed to assess the hepatotoxicity of raltegravir (RAL)- versus efavirenz (EFV)-based therapy when used as first-time ART in combination with tenofovir disoproxil fumarate and emtricitabine. Baseline pre-ART values were compared with those from ART-naive HIV-monoinfected and HIV-seronegative individuals. Before ART, HIV/HCV-coinfected individuals had higher levels of neopterin, sCD14, and sCD163, and increased frequencies of CD38+HLA-DR+, PD1+, and TIGIT+ CD4 and CD8 T cells compared with ART-naive HIV-monoinfected or HIV-seronegative individuals (all p < .01). Most parameters did not normalize despite 72 weeks of ART. In particular sCD163 persisted at high levels. Improvement over 72 weeks in fibrosis as assessed by FibroScan® correlated with reductions in plasma sCD163 and in the frequencies of T cell activation, single PD1+, TIGIT+, and dual PD1+TIGIT+ CD8 T cells. A nonsignificant tendency toward more favorable effects on monocyte and T cell immune activation and on T cell exhaustion were seen with RAL-compared with EFV-based therapy. The initiation of ART in HIV/HCV-coinfected individuals is associated with incomplete improvement in monocyte and T cell immune activation and exhaustion, which was associated with some corresponding improvement in liver fibrosis.
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Affiliation(s)
- Cecilia M. Shikuma
- Hawaii Center for AIDS, Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - Thuy Le
- Hawaii Center for AIDS, Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii, USA
- Division of Infectious Diseases and International Health, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Thao Vu Phuong
- Department of Medicine, University of Saskatchewan, Saskatoon, Canada
- Saskatchewan Infectious Disease Care Network, Saskatoon, Canada
| | - Glen M. Chew
- Hawaii Center for AIDS, Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | | | - Trieu Ly Vo
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
- Department of Infectious Diseases, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Chathura Siriwardhana
- Hawaii Center for AIDS, Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - Dominic Chow
- Hawaii Center for AIDS, Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - Hayk Ghukasyan
- Hawaii Center for AIDS, Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - Nath Limpruttidham
- Hawaii Center for AIDS, Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - Thomas Premeaux
- Hawaii Center for AIDS, Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - Louie Mar Gangcuangco
- Hawaii Center for AIDS, Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - Robert Paul
- Department of Psychological Sciences, Missouri Institute of Mental Health, University of Missouri–St. Louis, St. Louis, Missouri, USA
| | - Lishomwa C. Ndhlovu
- Hawaii Center for AIDS, Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii, USA
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Bhuiyan AR, Mitra AK, Ogungbe O, Kabir N. Association of HCV Infection with C-Reactive Protein: National Health and Nutrition Examination Survey (NHANES), 2009⁻2010. Diseases 2019; 7:diseases7010025. [PMID: 30813467 PMCID: PMC6473745 DOI: 10.3390/diseases7010025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 02/18/2019] [Accepted: 02/21/2019] [Indexed: 01/08/2023] Open
Abstract
The relationship between hepatitis C virus (HCV) infection and C-reactive protein (CRP), which is an inflammatory biomarker, is limited in studies with the general population. It was hypothesized that changes in CRP levels are genotype-dependent in the general population with HCV infection. Thus, this study aimed to assess the prevalence of HCV infection and compare CRP levels with an anti-HCV antibody, HCV-RNA status, and HCV genotypes. A total of 5611 adult participants from the National and Health Nutrition Examination (NHANES), 2009⁻2010 survey were analyzed. Proc survey frequency, means, and multivariate regression were used due to the complex survey design of NHANES. The prevalence of HCV infection among the study population was 1.6%. There were lower mean CRP levels among people with anti-HCV antibody positive status compared to those with antibody negative status (0.12 ± 0.08 vs. 0.24 ± 0.02, p = 0.08, 95% Confidence Intervals, CI: -1.12 to 0.07). Mean CRP levels were also lower in people with HCV-RNA positive status compared to those with HCV-RNA negative status (0.56 ± 0.03 vs. 0.48 ± 0.05, p = 0.62 and 95% CI: -1.37 to 0.86). However, these differences were non-significant. With respect to HCV genotypes, significantly higher CRP levels were noted among people infected with HCV genotype 2 vs. genotype 1 (0.53 ± 0.06 vs. 0.23 ± 0.05, p < 0.01, 95% CI: -0.58 to -0.02) and those with HCV genotype 2 vs. HCV genotype 3 (0.53 ± 0.06, 0.28 ± 0.04, p < 0.01, 95% CI: 0.02 to 0.48). Further studies are needed to confirm this finding.
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Affiliation(s)
- Azad R Bhuiyan
- Department of Epidemiology and Biostatistics, School of Public Health, Jackson State University, Jackson, MS 39213, USA.
| | - Amal K Mitra
- Department of Epidemiology and Biostatistics, School of Public Health, Jackson State University, Jackson, MS 39213, USA.
| | - Oluwabunmi Ogungbe
- Department of Epidemiology and Biostatistics, School of Public Health, Jackson State University, Jackson, MS 39213, USA.
| | - Nusrat Kabir
- Department of Epidemiology and Biostatistics, School of Public Health, Jackson State University, Jackson, MS 39213, USA.
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Abstract
GOALS To determine the impact of geography and patient characteristics on hepatitis C virus (HCV) genotype and subtype distribution in a large sample of patients under routine clinical care BACKGROUND:: HCV genotype impacts disease course and response to treatment. Although several studies have reported genotype distribution within specific US populations, there are no comprehensive descriptions in large, geographically diverse cohorts. STUDY Using data from the Chronic Hepatitis Cohort Study, we present the distribution of HCV genotypes (GT) and subtypes (ST) among a racially diverse cohort of over 8000 HCV-infected patients from four large US health systems. RESULTS Genotype distribution varied significantly by geographic and demographic factors. In age-adjusted analyses, African American patients had significantly higher prevalence of GT1 (85%) than other racial categories, largely driven by a markedly higher proportion of GT1 subtype b (∼34%) than in Asian/other (24%) and white (21%) patients. GT3 represented an increasing proportion of infections as birth decade progressed, from 4% in patients born before 1946 to 18% of those born after 1976. Within the cohort of "living/uncured" patients, highly elevated alanine aminotransferase (>2 times the upper limit of normal) was significantly more common in GT3 patients, whereas Fibrosis-4 Index scores indicative of cirrhosis were most common in the combined group of GT4&6 patients. CONCLUSION Distribution of HCV genotypes and subtypes in the United States is more variable than suggested by previous national-level estimates and single-center studies. "Real-world" prevalence data may improve targeting of prevention, screening, and treatment efforts for hepatitis C.
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