HCV specific immune reconstitution after treatment in HIV/HCV co-infected individuals

URIOSTE, ALEJANDRA; POLO, MARÍA LAURA; OSEGUEDA, ARIEL; GABRIELA TURK; FLORENCIA QUIROGA; LAUFER, NATALIA

Conferencia; 18th European AIDS Conference (EACS 2021); 2021

British HIV Association

Purpose: The aim of this research was to evaluate the impactof HCV clearance by direct antiviral agents (DAA) inthe specific immune response to HCV in HIV/HCV coinfectedindividuals.Method: This was a prospective longitudinal study were11 HIV/HCV coinfected individuals with a diagnosis compatiblewith METAVIR F4 were enrolled. All individualswere on successful antiretroviral therapy and began HCVtreatment with sofosbuvir/daclatasvir ± ribavirin for 12 or24 weeks. Peripheral blood samples were taken at differentstages of HCV treatment: before DAA (BSL), end of treatment(EOT) and 12 months post treatment (12MPT). HIVviral load, CD4 and CD8 T cells were measure. Peripheralblood mononuclear cells were obtained, incubated for 4days under the stimulation with peptides spanning structural(core, E1 and P7) and non-structural(NS4a, NS5a andNS4b) HCV proteins. Interferon-γwas measured in cellculture supernatants by ELISA (BioLegend) after stimulation.Non parametric test was used for statistical analysis.Results: A significant increase in the specific responseto NS4a/NS4b and NS5a was observed between BSL andEOT (P = 0.0156 and 0.0469, respectively). Absolute andpercentual CD4 T cell counts at BSL positively correlatedwith the magnitude of the specific response to NS4a/NS4bat EOT (P = 0.0267 r = 0.7447 and P = 0.0219 r = 0.7615,respectively). The overall specific response to structuralpeptides correlated positively with CD4 values (P = 0.0096r = 0.5175 absolute CD4, p = 0.0461 r = 0.4109 CD4%).Conclusions: The improvement in the specific cellularresponse to HCV after viral clearance may be due to theelimination of chronic stimulation by HCV antigens,which would reduce the depletion of cells and allow the proliferation of specific cells upon re-stimulationin vitro. A better immunological status before DAA initiationcorrelates with a higher recovery of specific cellularresponse which emphasizes the importance of early HIVtreatment initiation to preserve the immune response.