School of Medicine, University of Indonesia/Cipto Mangunkusomo Hospital, Jakarta, Indonesia.
Clin Immunol. 2011 Apr;139(1):32-9. doi: 10.1016/j.clim.2010.12.013. Epub 2011 Feb 5.
Some HIV/hepatitis C virus co-infected patients beginning ART experience Immune Restoration Disease (IRD) manifested as a rise in serum alanine transaminase. This was investigated in HIV/HCV co-infected individuals (n=50) commencing ART in Jakarta (Indonesia). Samples were collected at weeks 0, 4, 8, 12, 24 and at HCV IRD. Nine patients experienced HCV IRD (incidence=9.2 per 1000 person-weeks). These resolved without changing treatment. Markers of T-cell activation (sCD26, sCD30) and immune recruitment (CXCL10) increased in many HCV IRD cases, so T-cells may mediate HCV IRD. Total anti-HCV antibody (core, NS3, NS4) remained lower in HCV IRD cases, but levels of antibody to core were not lower in HCV IRD cases. Rises in HCV RNA on ART were independent of HCV IRD, but there was a negative correlation between baseline HCV RNA and total anti-HCV antibody. High levels of antibody may protect against HCV IRD, via lower HCV antigen loads.
一些开始接受抗逆转录病毒治疗（ART）的 HIV/丙型肝炎病毒（HCV）合并感染者会出现免疫重建疾病（IRD），表现为血清丙氨酸氨基转移酶升高。本研究纳入了在雅加达（印度尼西亚）开始接受 ART 的 HIV/HCV 合并感染者（n=50）。在 0、4、8、12、24 周以及 HCV IRD 时采集样本。9 名患者发生 HCV IRD（发生率=9.2/1000 人年）。这些患者未改变治疗方案，IRD 即自行消退。许多 HCV IRD 患者的 T 细胞活化标志物（sCD26、sCD30）和免疫募集标志物（CXCL10）升高，提示 T 细胞可能介导了 HCV IRD。HCV IRD 患者的总抗 HCV 抗体（核心、NS3、NS4）仍较低，但 HCV IRD 患者的核心抗体水平并不低。ART 治疗期间 HCV RNA 的升高与 HCV IRD 无关，但基线 HCV RNA 与总抗 HCV 抗体呈负相关。高水平的抗体可能通过降低 HCV 抗原载量来预防 HCV IRD。
