LAPI, Laboratório de Pesquisa em Infectologia, Department of Medicine, Complexo Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil.
LAPI, Laboratório de Pesquisa em Infectologia, Complexo Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil.
J Acquir Immune Defic Syndr. 2018 Feb 1;77(2):230-234. doi: 10.1097/QAI.0000000000001576.
HIV, hepatitis C virus (HCV), and human T-cell lymphotropic virus type 1 (HTLV-1) share the same routes of infection, making coinfection by these viruses a frequent finding in endemic areas. However, there is scarce information on the clinical/immunological consequences of triple infection. Coinfection by HTLV-1 is able to modulate cytokine's production in patients with HIV, but there are no data on the immune response of HIV-HCV-HTLV-1-infected patients.
We compared the plasma levels of 25 different cytokines in patients with HIV-HCV, according to their serostatus to HTLV-1 infection. Eligible patients should be on stable highly active antiretroviral therapy and have undetectable HIV-1 plasma viral load for, at least, 12 months. Cytokines levels were also evaluated by CD4 cells count, rates of sustained virological response (SVR) to previous HCV treatment, frequency of spontaneous HCV clearance, and HCV/IFN-λ3 genotypes.
Twenty-five patients (15 coinfected by HIV and HCV, 10 coinfected by HIV, HCV, and HTLV-1) were evaluated. Among the triply infected group, 3 had undetectable HCV viremia (spontaneous clearance). All but one remaining patients were previously treated for HCV, with similar SVR rates (∼29%). Cytokines levels did not differ per HCV/IFN-λ3 genotypes, mean CD4 cells count, age, sex, or SVR. However, patients coinfected by HTLV-1 showed significantly higher levels of IL-1b, IL-2, TNF-α, IFN-γ, MIP-1α, RANTES, and interferon-induced protein 10 (IP-10) than HIV-HCV-coinfected ones. Patients presenting HCV spontaneous clearance had the highest levels of cytokines.
Coinfection by HTLV-1 increases the plasma levels of proinflammatory cytokines of patients with HIV-HCV and can influence the outcomes of coinfected patients.
HIV、丙型肝炎病毒（HCV）和人类 T 细胞嗜淋巴细胞病毒 1 型（HTLV-1）具有相同的感染途径，因此在流行地区经常会同时感染这些病毒。然而，关于三重感染的临床/免疫学后果的信息却很少。HTLV-1 感染能够调节 HIV 患者细胞因子的产生，但关于 HIV-HCV-HTLV-1 感染患者免疫反应的数据却没有。
我们比较了 HIV-HCV 患者的血浆中 25 种不同细胞因子的水平，根据他们的 HTLV-1 感染血清学状态进行分组。符合条件的患者应接受稳定的高效抗逆转录病毒治疗，且 HIV-1 血浆病毒载量至少 12 个月内不可检测。细胞因子水平还通过 CD4 细胞计数、既往 HCV 治疗的持续病毒学应答（SVR）率、自发 HCV 清除的频率以及 HCV/IFN-λ3 基因型进行评估。
共评估了 25 名患者（15 名同时感染 HIV 和 HCV，10 名同时感染 HIV、HCV 和 HTLV-1）。在三重感染组中，3 名患者的 HCV 病毒血症（自发清除）不可检测。除 1 名患者外，其余患者均曾接受过 HCV 治疗，SVR 率相似（约 29%）。细胞因子水平与 HCV/IFN-λ3 基因型、平均 CD4 细胞计数、年龄、性别或 SVR 无关。然而，同时感染 HTLV-1 的患者的 IL-1b、IL-2、TNF-α、IFN-γ、MIP-1α、RANTES 和干扰素诱导蛋白 10（IP-10）水平显著高于 HIV-HCV 共感染患者。自发清除 HCV 的患者的细胞因子水平最高。
HTLV-1 共感染增加了 HIV-HCV 患者的促炎细胞因子血浆水平，并可能影响共感染患者的结局。
