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Martín-Escolano R, Virseda-Berdices A, Berenguer J, González-García J, Brochado-Kith O, Fernández-Rodríguez A, Díez C, Hontañon V, Resino S, Jiménez-Sousa MÁ. Predictive plasma biomarkers of long-term increase in hepatic steatosis index after HCV eradication in HIV/HCV-coinfected patients. Biomed Pharmacother 2023; 164:114913. [PMID: 37216704 DOI: 10.1016/j.biopha.2023.114913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/17/2023] [Accepted: 05/18/2023] [Indexed: 05/24/2023] Open
Abstract
Hepatic steatosis is a common condition found in the liver of hepatitis C virus (HCV)-infected patients, contributing to more severe forms of liver disease. In addition, the human immunodeficiency virus (HIV) may accelerate this process. Alternatively, several immune checkpoint proteins have been reported to be upregulated and correlated with disease progression during HCV and HIV infections. In steatosis, a detrimental immune system activation has been established; however, the role of the immune checkpoints has not been addressed so far. Thus, this study aimed to evaluate the association between plasma immune checkpoint proteins at baseline (before antiviral therapy) with hepatic steatosis index (HSI) increase at the end of follow-up (∼ five years after sustained virologic response (SVR)). We performed a multicenter retrospective study in 62 patients coinfected with HIV/HCV who started antiviral therapy. Immune checkpoint proteins were analyzed at baseline using a Luminex 200TM analyzer. The statistical association analysis was carried out using Generalized Linear Models (GLM) and Partial Least Squares Discriminant Analysis (PLS-DA). Fifty-three percent of the patients showed HSI increase from baseline to the end of follow-up. Higher immune checkpoint protein levels of BTLA, CD137(4-1BB), CD80, GITR, LAG-3, and PD-L1 before HCV therapy were associated with a long-term increase in HSI after successful HCV therapy, suggesting a potential predictive role for early detection of progression towards steatosis in HIV/HCV-coinfected patients.
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Affiliation(s)
- Rubén Martín-Escolano
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología (CNM), Instituto de Salud Carlos III (ISCIII), Majadahonda, Madrid, Spain
| | - Ana Virseda-Berdices
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología (CNM), Instituto de Salud Carlos III (ISCIII), Majadahonda, Madrid, Spain; Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Juan Berenguer
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Unidad de Enfermedades Infecciosas/VIH; Hospital General Universitario "Gregorio Marañón", Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Juan González-García
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Servicio de Medicina Interna-Unidad de VIH. Hospital Universitario La Paz. Madrid, Spain; Instituto de Investigación Sanitaria La Paz (IdiPAZ). Madrid, Spain
| | - Oscar Brochado-Kith
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología (CNM), Instituto de Salud Carlos III (ISCIII), Majadahonda, Madrid, Spain; Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Amanda Fernández-Rodríguez
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología (CNM), Instituto de Salud Carlos III (ISCIII), Majadahonda, Madrid, Spain; Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Cristina Díez
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Unidad de Enfermedades Infecciosas/VIH; Hospital General Universitario "Gregorio Marañón", Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Victor Hontañon
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Servicio de Medicina Interna-Unidad de VIH. Hospital Universitario La Paz. Madrid, Spain; Instituto de Investigación Sanitaria La Paz (IdiPAZ). Madrid, Spain
| | - Salvador Resino
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología (CNM), Instituto de Salud Carlos III (ISCIII), Majadahonda, Madrid, Spain; Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | - María Ángeles Jiménez-Sousa
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología (CNM), Instituto de Salud Carlos III (ISCIII), Majadahonda, Madrid, Spain; Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
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Grubczak K, Grzeszczuk A, Groth M, Hryniewicz A, Kretowska-Grunwald A, Flisiak R, Moniuszko M. Effects of Pegylated Interferon Alpha and Ribavirin (pegIFN-α/RBV) Therapeutic Approach on Regulatory T Cells in HCV-Monoinfected and HCV/HIV-Coinfected Patients. Viruses 2021; 13:v13081448. [PMID: 34452314 PMCID: PMC8402834 DOI: 10.3390/v13081448] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/10/2021] [Accepted: 07/20/2021] [Indexed: 02/07/2023] Open
Abstract
Approximately 25% of HIV-infected patients are co-infected with HCV. Notably, the burden of HCV infection (e.g., viral persistence, viral load, or HCV-related liver symptoms) is more pronounced in the presence of HIV co-infection. However, to date, the underlying immune mechanisms accounting for accelerated disease progression in HIV/HCV-coinfected individuals have not been described in sufficient detail. We hypothesized that regulatory T cells (Treg) bearing potent immunosuppressive capacities could not only play a substantial role in the pathogenesis of HCV/HIV coinfection but also modulate the response to the standard anti-viral therapy. MATERIALS AND METHODS To this end, we studied alterations in frequencies of Treg cells in correlation with other Treg-related and virus-related parameters in both HCV and HCV/HIV-infected patients subjected to standard pegIFN-α/RBV therapy. RESULTS Notably, we found that pegIFN-α/RBV therapy significantly increased levels of Treg cells in HCV-infected but not in HIV/HCV-coinfected individuals. Furthermore, HIV/HCV-coinfection was demonstrated to inhibit expansion of regulatory T cells during anti-viral treatment; thus, it might probably be responsible for viral persistence and HCV-related liver damage. CONCLUSIONS Therapy with pegIFN-α/RBV demonstrated a significant effect on regulatory T cells in the course of HIV and/or HCV infection indicating a crucial role in the anti-viral immune response.
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Affiliation(s)
- Kamil Grubczak
- Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, 15-269 Białystok, Poland;
- Correspondence: (K.G.); (M.M.); Tel./Fax: +48-85-748-59-72 (K.G. & M.M.)
| | - Anna Grzeszczuk
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, 15-540 Bialystok, Poland;
| | - Monika Groth
- Department of Allergology and Internal Medicine, Medical University of Bialystok, 15-089 Bialystok, Poland;
| | - Anna Hryniewicz
- Department of Rehabilitation, Medical University of Bialystok, 15-089 Bialystok, Poland;
| | - Anna Kretowska-Grunwald
- Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, 15-269 Białystok, Poland;
| | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, 15-540 Bialystok, Poland;
| | - Marcin Moniuszko
- Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, 15-269 Białystok, Poland;
- Department of Allergology and Internal Medicine, Medical University of Bialystok, 15-089 Bialystok, Poland;
- Correspondence: (K.G.); (M.M.); Tel./Fax: +48-85-748-59-72 (K.G. & M.M.)
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Corma-Gómez A, Macías J, Lacalle-Remigio JR, Téllez F, Morano L, Rivero A, Serrano M, Ríos MJ, Vera-Méndez FJ, Alados JC, Real LM, Palacios R, Santos IDL, Imatz A, Pineda JA. HIV infection is associated with lower risk of hepatocellular carcinoma after sustained virological response to direct-acting antivirals in hepatitis C infected-patients with advanced fibrosis. Clin Infect Dis 2020; 73:e2109-e2116. [PMID: 32766891 DOI: 10.1093/cid/ciaa1111] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The aim of this study was to assess the impact of HIV infection on the risk of developing hepatocellular carcinoma (HCC) in HCV-infected patients who achieve sustained virological response (SVR) with direct-acting antiviral (DAA). METHODS Multisite prospective cohort study, where HCV-monoinfected patients and HIV/HCV-coinfected individuals were included if they met: 1) SVR with DAA-based combination; 2) Liver stiffness (LS) ≥9.5 kPa previous to treatment; 3) LS measurement at the SVR time-point. The main endpoint was the occurrence of HCC. Propensity score (PS) was calculated to address potential confounders due to unbalanced distribution of baseline characteristics of HIV/HCV-coinfected and HCV-monoinfected patients. RESULTS 1035 HCV-infected patients were included, 667 (64%) coinfected with HIV. After a median (Q1-Q3) follow-up time of 43 (31-49) months, 19 (1.8%) patients developed HCC [11 (3.0%) HCV-monoinfected, 8(1.2%) HIV/HCV-coinfected individuals; p=0.013]. In the multivariable analysis, HIV co-infection was associated with a lower adjusted risk of developing HCC [sHR=0.27, 95% IC (0.08-0.90); p=0.034]. Predictors of HCC emergence were: HCV genotype 3 [sHR=7.9 (2.5-24.9); p<0.001], MELD score at SVR>10 [sHR=1.37 (1.01-1.86); p=0.043] and LS value at SVR [sHR=1.03 (1.01-1.06) for 1 kPa increase; p=0.011]. Using inverse probability weighting method on the PS, HIV-infected patients had a lower risk of HCC [powered HR=0.33 (0.11-0.85)]. CONCLUSIONS Among HCV-infected patients with advanced fibrosis, who achieve SVR with DAA, HIV-coinfection seems to be associated with a lower risk of HCC occurrence. The underlying causes for this finding need to be investigated.
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Affiliation(s)
- A Corma-Gómez
- Unit of Infectious Diseases and Microbiology. Hospital Universitario de Valme. Seville. Spain
| | - J Macías
- Unit of Infectious Diseases and Microbiology. Hospital Universitario de Valme. Seville. Spain
| | - J R Lacalle-Remigio
- Division of Preventive Medicine and Public Health, Faculty of Medicine, Universidad de Sevilla, Spain
| | - F Téllez
- Unit of Infectious Diseases, Hospital Universitario de Puerto Real, Faculty of Medicine, Cadiz, Spain
| | - L Morano
- Unit of Infectious Pathology, Hospital Universitario Alvaro Cunqueiro, Vigo, Spain
| | - A Rivero
- Unit of Infectious Diseases, Hospital Universitario Reina Sofia, Córdoba, Spain
| | - M Serrano
- UnitofInfectiousDiseases, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain
| | - M J Ríos
- Unit of Infectious Diseases, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - F J Vera-Méndez
- Section of Infectious Medicine/Service of Internal Medicine, Hospital General Universitario Santa Lucía, Cartagena, Spain
| | - J C Alados
- Unit of Clinical Microbiology, University Hospital Jerez, Cadiz, Spain
| | - L M Real
- Unit of Immunology, Biochemistry, Molecular Biology and Surgery, Faculty of Medicine, University of Malaga, Spain
| | - R Palacios
- Unit of Infectious Diseases and Microbiology, Hospital Virgen de la Victoria, Málaga, Spain
| | - I De Los Santos
- Unit of Internal Medicine and Infectious Diseases, Hospital La Princesa, Madrid, Spain
| | - A Imatz
- Unit of Infectious Diseases, Hospital Universitario Bellvitge, Barcelona, Spain
| | - J A Pineda
- Unit of Infectious Diseases and Microbiology. Hospital Universitario de Valme. Seville. Spain
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Domínguez-Domínguez L, Lagarde M, Bisbal O, Matarranz M, Rubio R, Pulido F. Sustained virological response at week 12 after interferon-free therapy as criterion for HCV cure definition: Validation in a real-life cohort of HIV-coinfected patients. Enferm Infecc Microbiol Clin 2019; 38:275-278. [PMID: 31668860 DOI: 10.1016/j.eimc.2019.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 07/07/2019] [Accepted: 07/25/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Sustained virological response (SVR) 12 weeks after the end-of-therapy (EOT) has been correlated with SVR24 for HCV-monoinfection. We aim to validate SVR12 as criterion for definition of HCV cure in HIV-coinfected patients treated with all-oral direct-acting antivirals (DAA). METHODS Prospectively observational study including HIV/HCV-coinfected subjects who received DAA and had HCV-RNA measures at weeks 12 and 24 after EOT. Every patient who took ≥1 drug dose was analyzed. RESULTS DAA were prescribed to 423 patients, of whom 387 had HCV-RNA measures both at weeks 12 and 24 after EOT. SVR12 was confirmed in 379/387 patients, while SVR24 was confirmed in 377/387 subjects. The positive-predictive-value (PPV) of SVR12 for SVR24 was 99.5% (95%CI: 98.1-99.9). One of the recurrences was clinically suspected to be a late relapse. CONCLUSIONS SVR12 has a high PPV for HCV cure in HIV/HCV-coinfection, though further follow-up could be necessary for those with deeper immunosuppression.
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Affiliation(s)
- Lourdes Domínguez-Domínguez
- HIV Unit, Internal Medicine Department, Biomedical Research Institute Imas12, Hospital Universitario 12 de Octubre, Madrid, Spain.
| | - María Lagarde
- HIV Unit, Internal Medicine Department, Biomedical Research Institute Imas12, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Otilia Bisbal
- HIV Unit, Internal Medicine Department, Biomedical Research Institute Imas12, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Mariano Matarranz
- HIV Unit, Internal Medicine Department, Biomedical Research Institute Imas12, Hospital Universitario 12 de Octubre, Madrid, Spain; Servicio de Medicina Interna, Hospital Infanta Leonor, Madrid, Spain
| | - Rafael Rubio
- HIV Unit, Internal Medicine Department, Biomedical Research Institute Imas12, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Federico Pulido
- HIV Unit, Internal Medicine Department, Biomedical Research Institute Imas12, Hospital Universitario 12 de Octubre, Madrid, Spain
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Salmon D, Bani-Sadr F, Gilbert C, Rosenthal E, Valantin MA, Simon A, Neau D, Morlat P, Loko MA, Wittkop L, Dabis F. HCV viral load at baseline and at week 4 of telaprevir/boceprevir based triple therapies are associated with virological outcome in HIV/hepatitis C co-infected patients. J Clin Virol 2015; 73:32-35. [PMID: 26528903 DOI: 10.1016/j.jcv.2015.10.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 10/14/2015] [Accepted: 10/16/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND As first generation HCV-specific protease inhibitors, boceprevir (BOC) or telaprevir (TVR) can achieve 60% to 70% sustained virological response (SVR) for HCV infected patients with genotype 1 infections, they could remain temporary a therapeutic option in patients living in resources limited countries with limited access to the new anti-HCV direct acting antiviral (DAA) drugs, such as sofosbuvir. OBJECTIVES AND STUDY DESIGN Here we evaluated in a routine practice setting, the treatment responses, tolerance and factors associated with SVR of a triple therapy with BOC or TVR, combined with pegylated interferon and ribavirin (PegIFN/RBV) in HIV/HCV co-infected patients, included in a large cohort of HIV/HCV coinfected patients (ANRS CO13-HEPAVIH). RESULTS Among the 89 HIV/HCV coinfected patients treated, 65% of whom were previous non-responders to PegIFN/RBV therapy, 65%, 55% and 41% had at baseline genotype 1a, a high baseline HCV-RNA (≥800,000 IU/ml) and a cirrhosis, respectively. The SVR12 rate was 63% overall, 53% for BOC-based regimen and 66% for TVR-based regimen. In multivariate analysis, two factors were significantly associated with HCV SVR: HCV viral load <800,000 IU/mL at treatment initiation versus ≥800,000 IU/mL (OR 4.403, 95% CI 1.29-15.04; p=0.018) and virological response at W4 (HCV-RNA undetectable after 4 weeks of triple therapy) (OR 3.35, 95% CI 1.07-10.48; p=0.038). CONCLUSIONS Overall SVR12 was 63% and our results suggest that HIV/HCV coinfected patients with low HCV viral load (<800,000 IU/mL) and undetectable HCV-RNA after 4 weeks of triple therapy with TVR or BOC-based regimen have a higher probability of treatment success.
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Affiliation(s)
- D Salmon
- Service des Maladies Infectieuses et Tropicales, Hôpital Cochin, APHP-Université Paris Descartes, Paris, France
| | - F Bani-Sadr
- Service des Maladies Infectieuses et Tropicales, CHU Reims, Université Champagne Ardenne, Reims, France.
| | - C Gilbert
- INSERM, ISPED, Center INSERM U897-Epidémiologie-Biostatistiques, F-33000 Bordeaux, France
| | - E Rosenthal
- Service de Médecine Interne, Hôpital de l'Archet, Nice, France
| | - M A Valantin
- Service des Maladies Infectieuses et Tropicales, Hôpital Pitié Salpêtrière-APHP, Paris, France
| | - A Simon
- Service de Médecine Interne, Hôpital Pitié Salpêtrière-APHP, Paris, France
| | - D Neau
- Service des Maladies Infectieuses et Tropicales, Hôpital Pellegrin, Bordeaux, France
| | - P Morlat
- Service de Médecine Interne et Maladies Infectieuses, CHU de Bordeaux, Bordeaux, France
| | - M A Loko
- INSERM, ISPED, Center INSERM U897-Epidémiologie-Biostatistiques, F-33000 Bordeaux, France
| | - L Wittkop
- INSERM, ISPED, Center INSERM U897-Epidémiologie-Biostatistiques, F-33000 Bordeaux, France
| | - F Dabis
- INSERM, ISPED, Center INSERM U897-Epidémiologie-Biostatistiques, F-33000 Bordeaux, France
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