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Hepatitis C-associated autoimmunity in patients coinfected with HIV

Rainer P Woitas1, Bodo Stoschus, Birgit Terjung

  • 1Department of Internal Medicine I, University of Bonn, 53105 Bonn, Germany. Woitas@uni-bonn.de

Liver International : Official Journal of the International Association for the Study of the Liver
|December 14, 2005
PubMed

Insights

Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) coinfection significantly increases autoimmune antibodies like anti-thyroglobulin and anti-cardiolipin. Autoimmunity is common but rarely shows clinical symptoms in coinfected patients.

Area of Science:

  • Immunology
  • Virology
  • Hepatology

Background:

  • Hepatitis C virus (HCV) infection is linked to various extrahepatic conditions.
  • The impact of extrahepatic manifestations in patients coinfected with HIV and HCV remains unclear.

Purpose of the Study:

  • To prospectively evaluate the frequency of autoimmune manifestations in patients with HIV/HCV coinfection.
  • To compare autoimmune profiles between HIV/HCV-coinfected, HIV-mono-infected, and HCV-mono-infected individuals.

Main Methods:

  • Prospective assessment of autoimmune manifestations in 98 HIV/HCV-coinfected, 45 HIV-mono-infected, and 78 HCV-mono-infected patients.
  • Measurement of diagnostic vasculitis scores, viral loads (HCV and HIV), CD4 cell counts, and specific autoantibodies (thyroid, cardiolipin, non-organ-specific), and cryoglobulins.

Main Results:

  • Synergistic effects of HCV and HIV coinfection significantly increased prevalence of anti-thyroglobulin (30.6% vs 15.4% HCV, 8.8% HIV) and anti-cardiolipin antibodies (46% vs 9.0% HCV, 31% HIV).
  • Cryoglobulinemia type III was associated with HCV infection (25.6% HCV, 20.4% HIV/HCV) but not HIV infection (4.4%).
  • Rheumatoid factor was frequent in HCV (48%) but less so in HIV (4.4%) or HIV/HCV (9.5%) coinfection.

Conclusions:

  • HIV coinfection differentially modulates the frequency of HCV-related autoimmunity.
  • Autoimmune conditions in coinfected patients are seldom accompanied by overt clinical symptoms.
Abstract

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