Feuth Thijs, van Baarle Debbie, van Erpecum Karel J, Siersema Peter D, Hoepelman Andy I M, Arends Joop E
Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht (UMCU), Huispostnummer F.02.126, P.O. Box 85500, 3508, GA, Utrecht, The Netherlands.
Eur J Clin Microbiol Infect Dis. 2014 Jul;33(7):1113-7. doi: 10.1007/s10096-014-2053-7. Epub 2014 Jan 22.
The extent of liver fibrosis is an important factor in prognosis and clinical decision-making in chronic hepatitis C virus (HCV) infection. We investigated CD4/CD8 ratio in HCV-monoinfected and HIV/HCV-coinfected patients, in order to reveal its relation with liver fibrosis. CD4/CD8 ratio in the peripheral blood was assessed by flow cytometry in a cohort of 19 HCV-monoinfected, 14 HIV/HCV-coinfected, ten HIV-monoinfected patients and 15 healthy controls. Liver fibrosis was assessed by transient elastography (n = 25) or by liver biopsy (n = 8). Coinfection with HIV was associated with decreased CD4/CD8 ratios in chronic HCV-infected patients, despite adequate antiretroviral treatment. Furthermore, HCV-monoinfected patients with F3-F4 liver fibrosis demonstrated much lower CD4/CD8 ratios than patients with F0-F2 fibrosis (1.4 versus 2.5, p = 0.023). Similarly, we observed a strong negative correlation between the CD4/CD8 ratio and liver stiffness measured by transient elastography (R = -0.78, p = 0.0006). ROC analysis revealed that CD4/CD8 ratio as a non-invasive marker for fibrosis is very promising (area under the curve 0.8). Although our study was performed with a relatively small number of patients, our findings suggest that the CD4/CD8 ratio is a promising candidate for non-invasive evaluation of liver fibrosis in HCV-monoinfected patients.
肝纤维化程度是慢性丙型肝炎病毒（HCV）感染患者预后及临床决策的重要因素。我们研究了HCV单一感染和HIV/HCV合并感染患者的CD4/CD8比值，以揭示其与肝纤维化的关系。通过流式细胞术评估了19例HCV单一感染患者、14例HIV/HCV合并感染患者、10例HIV单一感染患者及15例健康对照外周血中的CD4/CD8比值。采用瞬时弹性成像（n = 25）或肝活检（n = 8）评估肝纤维化。尽管进行了充分的抗逆转录病毒治疗，但HIV合并感染与慢性HCV感染患者CD4/CD8比值降低有关。此外，F3 - F4级肝纤维化的HCV单一感染患者的CD4/CD8比值显著低于F0 - F2级纤维化患者（1.4对2.5，p = 0.023）。同样，我们观察到CD4/CD8比值与瞬时弹性成像测量的肝脏硬度之间存在强烈的负相关（R = -0.78，p = 0.0006）。ROC分析显示，CD4/CD8比值作为纤维化的非侵入性标志物很有前景（曲线下面积为0.8）。尽管我们的研究样本量相对较小，但我们的研究结果表明，CD4/CD8比值是HCV单一感染患者肝纤维化非侵入性评估的一个有前景的指标。
