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Cellular immune responses to HCV core increase and HCV RNA levels decrease during successful antiretroviral therapy.

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Long-term combination antiretroviral therapy (cART) boosts Hepatitis C virus (HCV)-specific T cell responses in HIV-coinfected individuals. This treatment also leads to a modest reduction in HCV RNA levels, improving immune control.

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Area of Science:

  • Immunology
  • Virology
  • Infectious Diseases

Background:

  • Hepatitis C virus (HCV) infection significantly impacts morbidity in individuals with HIV coinfection.
  • HIV coinfection is linked to weaker HCV-specific immune responses and higher viral loads.

Purpose of the Study:

  • To determine if long-term combination antiretroviral therapy (cART) can restore HCV-specific T cell responses.
  • To assess if cART improves the control of HCV replication in coinfected individuals.

Main Methods:

  • Longitudinal evaluation of T cell responses using interferon-gamma-ELISpot assays against HCV core peptides in 80 HIV/HCV coinfected individuals.
  • Assessment of HCV RNA levels via real-time PCR in 114 individuals.

Main Results:

  • Detectable T cell responses to HCV core peptides increased from 19% before cART to 45-49% after 33-70 months (p=0.001).
  • HCV-specific immune responses improved in both chronic (+31%) and spontaneously cleared (+30%) HCV infections.
  • Median HCV RNA levels showed a slight decrease (-0.3 log10 IU/ml, p=0.02) during long-term cART.

Conclusions:

  • Effective cART is associated with enhanced cellular immune responses to HCV core peptides.
  • Long-term cART leads to a modest reduction in HCV RNA levels.
  • Findings support the favorable clinical impact of cART on hepatitis C progression and early treatment initiation in coinfected patients.