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HCV coinfection associated with slower disease progression in HIV-infected former plasma donors naïve to ART.

Zhang X, Xu J, Peng H, Ma Y, Han L, Ruan Y, Su B, Wang N, Shao Y - PLoS ONE (2008)

Bottom Line: During the 33-month follow-up, only 35% (7 out of 20 cases) HIV-1 mono-infected subjects remained their CD4+ T-cell counts above 200 cells/microl and retained on the cohort study, which was significantly lower than 56% (75 out of 135 cases) for HIV/HCV group and 69% (9 out of 13 cases) for HIV/HCV/Toxoplasma group (p<0.05).In accordance with those observations, HIV viral loads in HIV mono-infection group were consistently higher than that in HIV/HCV group though statistical significances were only reached at baseline (p = 0.04).It will be highly interesting to further explore the underlying mechanism for this observation in the future.

View Article: PubMed Central - PubMed

Affiliation: State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, China CDC, Beijing, China.

ABSTRACT

Background: It remains controversial how HCV coinfection influences the disease progression during HIV-1 infection. This study aims to define the influence of HCV infection on the replication of HIV-1 and the disease progression in HIV-infected former plasma donors (FPDs) naïve to ART.

Methodology/principal findings: 168 HIV-1-infected FPDs were enrolled into a cohort study from Anhui province in central China, and thereafter monitored at month 3, 9, 15, 21 and 33. Fresh whole blood samples were used for CD4+ T-cell counting. Their plasma samples were collected and stored for quantification of HIV-1 viral loads and for determination of HCV and Toxoplasma. Out of 168 HIV-infected FBDs, 11.9% (20 cases), 80.4% (135 cases) and 7.7% (13 cases) were infected with HIV-1 alone, HIV-1/HCV and HIV/HCV/Toxoplasma, respectively. During the 33-month follow-up, only 35% (7 out of 20 cases) HIV-1 mono-infected subjects remained their CD4+ T-cell counts above 200 cells/microl and retained on the cohort study, which was significantly lower than 56% (75 out of 135 cases) for HIV/HCV group and 69% (9 out of 13 cases) for HIV/HCV/Toxoplasma group (p<0.05). CD4+ T cells in HIV mono infection group were consistently lower than that in HIV/HCV group (p = 0.04, 0.18, 0.03 and 0.04 for baseline, month 9, month 21 and month 33 visit, respectively). In accordance with those observations, HIV viral loads in HIV mono-infection group were consistently higher than that in HIV/HCV group though statistical significances were only reached at baseline (p = 0.04).

Conclusions/significance: These data indicated HCV coinfection with HIV-1 is associated with the slower disease progression at the very late stage when comparing with HIV-1 mono-infection. The coinfection of Toxoplasma with HIV and HCV did not exert additional influence on the disease progression. It will be highly interesting to further explore the underlying mechanism for this observation in the future.

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Viral loads at different follow-up visits (a) and among different groups (b, c, d) during observation.The X axis indicates the different time-points of sampling at baseline (BL), month 3 (3M), month 9 (9M), month 15 (15M), month 21 (21M), month 33 (33M) after enrollment (a) or indicates different groups (b, c and d), and Y axis indicates the viral load (log10 copies/ml).
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pone-0003992-g003: Viral loads at different follow-up visits (a) and among different groups (b, c, d) during observation.The X axis indicates the different time-points of sampling at baseline (BL), month 3 (3M), month 9 (9M), month 15 (15M), month 21 (21M), month 33 (33M) after enrollment (a) or indicates different groups (b, c and d), and Y axis indicates the viral load (log10 copies/ml).

Mentions: To further determine the influence of HCV coinfection with HIV-1 on disease progression, we conducted a prospective cohort study and calculated the percentages of individuals whose CD4+ T-cell counts remained >200 cells/µl and retained on the cohort study. During 33 month follow up, the percentage of subjects with CD4+ T-cell counts >200 cells/µl in this cohort decreased at month 9 visit after entry (p<0.05) and continued to drop afterwards (p<0.01 for all other visits comparing to baseline data). At the final time point (33-month), only 51% of study subjects were remained with CD4+T cells over 200 cells/µl (Fig. 2a). We then examined the retaining rate by groups. As shown in figure 2b, no significant differences of the percentages among groups were observed during the first 9-month observation though the difference did appear at month 9 visit. These data were also supported by the observation from the baseline, 25.8% HIV-1 mono-infection cases (8 out 31 cases) had CD4+ T cells below 200 cells/µl, which is comparable to what observed in HIV/HCV dual infection group (65 out of 253 cases, 25.7%). However, during the prolonged observation (at month 15, month 21 and month 33 visits), significant less fractions of subjects from HIV/HCV dual infection or HIV/HCV/Toxoplasma triple infection progressed into AIDS stage defined as CD4+ T cells below 200 cells/µl (Fig. 2b). At the month 33 follow-up, only 35% HIV-1 mono-infected cases remained their CD4+ T-cell counts >200 cells/µl, which is significantly lower than that observed 56% in HIV/HCV dual infection group and 69% in HIV/HCV/Toxoplasma triple infection group. Furthermore, absolute CD4+ T-cell counts in HIV/HCV group were consistently higher than that in HIV mono-infection group (p = 0.04, 0.18, 0.03 and 0.04 for baseline, month 9, month 21 and month 33 visit, respectively). 20% (27 cases) retained their CD4+ T-cell counts >600 in HIV/HCV group even at month 33 visit whereas none does so in HIV mono-infection group since month 21 visit (Fig. 2c, d and e). In accordance with those observations above, HIV viral loads in HIV/HCV group were consistently lower than that in HIV-1 group though statistical significances were only reached at baseline (p = 0.04) (Fig. 1c) and not other visits (Fig. 3). These data indicated that HCV coinfection with HIV-1 may significantly slow down the disease progression and this effect may only manifest at the very late stage of HIV-1 infection.


HCV coinfection associated with slower disease progression in HIV-infected former plasma donors naïve to ART.

Zhang X, Xu J, Peng H, Ma Y, Han L, Ruan Y, Su B, Wang N, Shao Y - PLoS ONE (2008)

Viral loads at different follow-up visits (a) and among different groups (b, c, d) during observation.The X axis indicates the different time-points of sampling at baseline (BL), month 3 (3M), month 9 (9M), month 15 (15M), month 21 (21M), month 33 (33M) after enrollment (a) or indicates different groups (b, c and d), and Y axis indicates the viral load (log10 copies/ml).
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC2602976&req=5

pone-0003992-g003: Viral loads at different follow-up visits (a) and among different groups (b, c, d) during observation.The X axis indicates the different time-points of sampling at baseline (BL), month 3 (3M), month 9 (9M), month 15 (15M), month 21 (21M), month 33 (33M) after enrollment (a) or indicates different groups (b, c and d), and Y axis indicates the viral load (log10 copies/ml).
Mentions: To further determine the influence of HCV coinfection with HIV-1 on disease progression, we conducted a prospective cohort study and calculated the percentages of individuals whose CD4+ T-cell counts remained >200 cells/µl and retained on the cohort study. During 33 month follow up, the percentage of subjects with CD4+ T-cell counts >200 cells/µl in this cohort decreased at month 9 visit after entry (p<0.05) and continued to drop afterwards (p<0.01 for all other visits comparing to baseline data). At the final time point (33-month), only 51% of study subjects were remained with CD4+T cells over 200 cells/µl (Fig. 2a). We then examined the retaining rate by groups. As shown in figure 2b, no significant differences of the percentages among groups were observed during the first 9-month observation though the difference did appear at month 9 visit. These data were also supported by the observation from the baseline, 25.8% HIV-1 mono-infection cases (8 out 31 cases) had CD4+ T cells below 200 cells/µl, which is comparable to what observed in HIV/HCV dual infection group (65 out of 253 cases, 25.7%). However, during the prolonged observation (at month 15, month 21 and month 33 visits), significant less fractions of subjects from HIV/HCV dual infection or HIV/HCV/Toxoplasma triple infection progressed into AIDS stage defined as CD4+ T cells below 200 cells/µl (Fig. 2b). At the month 33 follow-up, only 35% HIV-1 mono-infected cases remained their CD4+ T-cell counts >200 cells/µl, which is significantly lower than that observed 56% in HIV/HCV dual infection group and 69% in HIV/HCV/Toxoplasma triple infection group. Furthermore, absolute CD4+ T-cell counts in HIV/HCV group were consistently higher than that in HIV mono-infection group (p = 0.04, 0.18, 0.03 and 0.04 for baseline, month 9, month 21 and month 33 visit, respectively). 20% (27 cases) retained their CD4+ T-cell counts >600 in HIV/HCV group even at month 33 visit whereas none does so in HIV mono-infection group since month 21 visit (Fig. 2c, d and e). In accordance with those observations above, HIV viral loads in HIV/HCV group were consistently lower than that in HIV-1 group though statistical significances were only reached at baseline (p = 0.04) (Fig. 1c) and not other visits (Fig. 3). These data indicated that HCV coinfection with HIV-1 may significantly slow down the disease progression and this effect may only manifest at the very late stage of HIV-1 infection.

Bottom Line: During the 33-month follow-up, only 35% (7 out of 20 cases) HIV-1 mono-infected subjects remained their CD4+ T-cell counts above 200 cells/microl and retained on the cohort study, which was significantly lower than 56% (75 out of 135 cases) for HIV/HCV group and 69% (9 out of 13 cases) for HIV/HCV/Toxoplasma group (p<0.05).In accordance with those observations, HIV viral loads in HIV mono-infection group were consistently higher than that in HIV/HCV group though statistical significances were only reached at baseline (p = 0.04).It will be highly interesting to further explore the underlying mechanism for this observation in the future.

View Article: PubMed Central - PubMed

Affiliation: State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, China CDC, Beijing, China.

ABSTRACT

Background: It remains controversial how HCV coinfection influences the disease progression during HIV-1 infection. This study aims to define the influence of HCV infection on the replication of HIV-1 and the disease progression in HIV-infected former plasma donors (FPDs) naïve to ART.

Methodology/principal findings: 168 HIV-1-infected FPDs were enrolled into a cohort study from Anhui province in central China, and thereafter monitored at month 3, 9, 15, 21 and 33. Fresh whole blood samples were used for CD4+ T-cell counting. Their plasma samples were collected and stored for quantification of HIV-1 viral loads and for determination of HCV and Toxoplasma. Out of 168 HIV-infected FBDs, 11.9% (20 cases), 80.4% (135 cases) and 7.7% (13 cases) were infected with HIV-1 alone, HIV-1/HCV and HIV/HCV/Toxoplasma, respectively. During the 33-month follow-up, only 35% (7 out of 20 cases) HIV-1 mono-infected subjects remained their CD4+ T-cell counts above 200 cells/microl and retained on the cohort study, which was significantly lower than 56% (75 out of 135 cases) for HIV/HCV group and 69% (9 out of 13 cases) for HIV/HCV/Toxoplasma group (p<0.05). CD4+ T cells in HIV mono infection group were consistently lower than that in HIV/HCV group (p = 0.04, 0.18, 0.03 and 0.04 for baseline, month 9, month 21 and month 33 visit, respectively). In accordance with those observations, HIV viral loads in HIV mono-infection group were consistently higher than that in HIV/HCV group though statistical significances were only reached at baseline (p = 0.04).

Conclusions/significance: These data indicated HCV coinfection with HIV-1 is associated with the slower disease progression at the very late stage when comparing with HIV-1 mono-infection. The coinfection of Toxoplasma with HIV and HCV did not exert additional influence on the disease progression. It will be highly interesting to further explore the underlying mechanism for this observation in the future.

Show MeSH
Related in: MedlinePlus