Evaluating the impact of hepatitis C virus (HCV) on highly active antiretroviral therapy-mediated immune responses in HCV/HIV-coinfected women: Role of HCV on expression of primed/memory T cells

Objective. To evaluate the impact of hepatitis C virus (HCV) on the immune system before receipt of highly active antiretroviral therapy (HAART) and on immune recovery after receipt of HAART among human immunodeficiency virus (HIV)/HCV-coinfected women enrolled in the Women's Interagency HIV Study. Methods. The study included 294 HIV-infected women who initiated HAART and attended 2 follow-up visits. The women were grouped on the basis of positive HCV antibody and HCV RNA tests. There were 148 women who were HCV antibody negative, 34 who were HCV antibody positive but RNA negative, and 112 who were HCV antibody and RNA positive. Immune recovery was measured by flow-cytometric assessment for markers of activation and maturation on CD4⁺ and CD8⁺ T cells. Data analysis used repeated measures of variance. Results. HIV/HCV coinfection is associated with an increased number of CD4 ⁺ and CD8⁺ primed/memory T cells. HIV/HCV coinfection, however, did not affect any further decreases in CD4⁺ or CD4 ⁺ and CD8⁺ naive/memory T cell counts or enhanced T cell activation. HIV/HCV coinfection also did not affect HAART responses in the CD4⁺ and CD8⁺ T cell compartment. Conclusions. HCV does not affect immune responses to HAART in HIV/HCV-coinfected individuals but is associated with an expansion of CD4⁺ and CD8⁺ memory T cell subsets. Functional impairment in the CD4⁺ and CD8⁺ T cell compartments still needs to be assessed in coinfected patients.