Células T CD4 y NK: Predictores de mayor fibrosis hepática en pacientes coinfectados por HIV/HCV

NATALIA LAUFER, DIEGO OJEDA,JAVIER URQUIZA, ANA MARTINEZ, ALICIA SISTO, MARÍA JOSÉ ROLÓN, NORBERTO ZWIRNER, HÉCTOR PÉREZ, PEDRO CAHN, JORGE QUARLERI

Mendoza

Congreso; XVI Congreso de la Sociedad Argentina de Infectología SADI; 2016

SADI

BackgroundBecause of overlapping pathways of transmission approximately 4-5 million individuals worldwide are HIV/HCV-coinfected. The high cost of HCV treatment and competing public health priorities restrict its use. It is crucial to identify patients at early disease stages but with high risk of fibrosis progression that would consequently require HCV treatment with urgency. NK cells regulate hepatic stellate cells that are responsible for liver fibrosis. Aim: identify NK phenotypes associated with fibrosis development in HIV/HCV-coinfected patients. M&MPBMC from 17 HIV/HCV coinfected and 5 HIV/HCV/HBV seronegative individuals were used. HIV/HCV coinfected patients were divided into: G1 patients with METAVIR F0-F2 and G2,patients with METAVIR F3-F4. Surface cell staining: anti-CD3(APC/Cy7), anti-CD56(PE/Cy5), anti-CD57(APC), anti-CD25(PE), anti-CD69(FITC), anti-NKp30(PE), anti-NKp46(PE/Cy7), anti-NKG2D(APC), anti-DNAM(FITC); anti-CD62L (PE/Cy7), anti-CCR7(PE), anti-TRAIL(PE), anti-FasL(PE), anti CD94(FITC).Flow cytometry data acquisition was performed on BD FACSCanto, analyzed using FlowJo software.Frequency of fluorescence was analyzed for all single markers. ResultsMean age was 44.6(SD8.4), 71% male. G1= 13 patients, G2= 4 patients.There was no difference in mean age, mean time of HIV and HCV infection among the two groups. All patients were on ARV, with undetectable HIV viral load. G1 had higher CD4 than G2(710 cells/µL,SD 238vs. 421 cell/µL,SD 158;p=0.007). When total number of NK cells was evaluated, G2 presented lower values (NK= 4.74 cells/µL, SD 1.06) compared both with G1(NK= 12,2 cells/µL, SD 7.9) and controls (NK= 12.2 cells/µL, SD 2.7), p 0.06 and 0.02 respectively . No major significant differences were observed between G1 and G2 surface markers. G2 vs G1: higher percentage of NK cells CD56 dim TRAIL+ (29.4% -SD 31.7- vs 7.5% -SD3.14-, p=0.042).Discussion In this study, we have observed that those subjects with higher fibrosis are those with lower absolute count both of CD4 and NK cells, but with no significant difference in the NK cell phenotype. These are two simple parameters to be evaluated in a routine laboratory test, and if these results are validated with a larger number of patients, they could be used as predictors of higher risk to advanced liver fibrosis and the need of urgent antiviral treatment.