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Intrahepatic CD4+ cell depletion in hepatitis C virus/HIV-coinfected patients

P Wilfredo Canchis1, Herman T Yee, M Isabel Fiel

  • 1Center for the Study of Hepatitis C, Department of Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA.

Journal of Acquired Immune Deficiency Syndromes (1999)
|August 21, 2004
PubMed

Insights

HIV coinfection with hepatitis C virus (HCV) leads to fewer liver CD4 cells and more lymphocyte apoptosis. This may negatively impact the progression of HCV infection in coinfected patients.

Area of Science:

  • Hepatology
  • Immunology
  • Virology

Background:

  • Coinfection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) exacerbates liver disease.
  • HIV/HCV coinfection is linked to increased liver inflammation, fibrosis, and poorer treatment outcomes.

Purpose of the Study:

  • To investigate intrahepatic immune cell and hepatocyte differences in patients coinfected with HIV and HCV versus those with HCV alone.
  • To correlate intrahepatic findings with peripheral viral load and CD4 counts.

Main Methods:

  • Quantification of intrahepatic lymphocytes and hepatocytes by a single pathologist in portal and lobular areas.
  • Comparison of cell counts between HCV-monoinfected and HIV/HCV-coinfected patient groups (n=41 vs. n=38).

Main Results:

  • Coinfected patients showed significantly fewer portal CD4 cells (4.97 vs. 10.58 cells/HPF) and more lobular apoptotic lymphocytes (0.64 vs. 0.16 cells/HPF).
  • Portal CD4 cell counts did not correlate with peripheral CD4 counts.
  • Increased portal proliferative hepatocytes were observed in coinfected patients with high HIV RNA levels (>400 copies/mL).

Conclusions:

  • HIV coinfection is associated with distinct intrahepatic immune alterations, including reduced portal CD4 cells and increased lymphocyte apoptosis.
  • These changes may influence the natural course and progression of hepatitis C virus infection in coinfected individuals.

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