Analysis of HCV genotypes in plasma and cell culture samples in a group of hemophilic HIV/HCV co-infected patients.

BASTÓN M; PARODI C; CULASSO A; DE BRACCO MM; RUIBAL ARES B; BARÉ P

Toulon, Francia

Simposio; 15th International Symposium on HIV and Emergent Infectious Diseases, ISHEID; 2008

Hemophilic patients have acquired HCV and HIV infections through contaminated clotting-factor concentrates before effective virus-inactivation procedures. As these individuals were likely to have been exposed several times to the HCV, multiple genotypes may circulate concomitantly in the same patient. The implementation of HAART on HIV/HCV co-infected patients and the subsequent immune recovery could put a differential selection pressure favoring viral clearance of some genotypes and/or the emergence of others. Using prolonged non stimulated peripheral blood mononuclear cell (PBMC) culture, the HCV genome can be detected allowing the analysis of HCV genotypes derived from these cells. As viral reservoirs, PBMC could potentially harbor HCV variants distinct from those found in plasma samples. We carried out PBMC cultures of 8 HIV/HCV co-infected patients and performed HCV genotyping analysis to compare genotypes from paired samples (plasma/culture supernatant). HCV genotyping was performed by RFLP technique. In order to estimate the effect of antiretroviral treatments on HCV genotype distribution, serial plasma samples obtained before and after HAART were analyzed. Culture supernatant samples of all of the patients showed at least one different HCV genotype in addition to the one detected in plasma samples. In 4/8 the presence of the genotypes that had emerged under PBMC cultures could be found in archived plasma samples corresponding to pre-HAART periods confirming the pre-existence of this particular genotype. In the remaining patients, the genotype found under culture did not appear in the serial plasma samples evaluated. No correlation between mixed HCV infections and HCV/ HIV viral loads, or CD4/CD8 T cell counts was found. The presence of additional genotypes in pre-HAART plasma samples illustrates the impact that HIV treatment could directly or indirectly exert on the distribution of HCV variants.