Summary
Interferon (IFN)-a induced CD4+ T lymphopenia is a toxic effect of the treatment of chronic hepatitis C virus (HCV) in human immunodeficiency virus (HIV)-co-infected patients. To increase the knowledge about this secondary effect, we performed an analysis of the evolution of the T cell receptor excision circles (TRECs), CD4+ and CD8 + T cells and of their CD45RO + and CD45RA+ subpopulations during the treatment of chronic hepatitis HCV with peginterferon alpha (pegIFN-a) + ribavirin. Twenty HCV/HIV-coinfected patients, with undetectable HIV load after highly active antiretroviral therapy (HAART), were treated with pegIFN-a + ribavirin. TRECs were determined using real-time polymerase chain reaction.
lymphocytes. A progressive decrease in both T cell populations, as well as of their CD45RO+ and CD45RA + subpopulations, was detected, with a difference between the baseline and nadir levels approaching 50%. The evolution of T cell populations and TRECs was independent of the response to the treatment. T lymphocytes and their subpopulations returned to baseline levels at 24 weeks after the end of treatment, with the exception of the T CD4 + CD45RA + subpopulation. The ratio of CD4 + CD45RO + /CD4 + CD45RA + increased from 0·89 (baseline) to 1·44 (24 weeks after the end of the therapy). TRECs/ml did not return to the basal values. In conclusion, a significant reduction of CD4 + and CD8 + T cells, and of their CD45RA + and CD45RO + subpopulations, in HIV/HCV co-infected patients treated with pegIFN-a was observed. Both subpopulations increased after the suppression of treatment, but the CD4 + CD45RA subpopulation did not reach the basal levels as a consequence, at least in part, of a decrease in thymic production.