Division of Infectious Diseases, Stroger Hospital of Cook County Heath.
Cook County Health and Hektoen Institute of Medicine, Chicago, Illinois.
AIDS. 2021 Jul 15;35(9):1433-1438. doi: 10.1097/QAD.0000000000002869.
Eradication of hepatitis C virus (HCV) in HIV disease decreases liver and non-liver-related morbidity and mortality. Elevated markers of monocyte/macrophage activation (soluble CD163 and sCD14) are associated with excess non-AIDS morbidity and mortality in HIV. We examined the effect of HCV eradication on these markers in relation to change in hepatic fibrosis.
A nested substudy within a longitudinal observational cohort.
We studied 126 HIV/HCV-coinfected women successfully treated for HCV, with undetectable HCV RNA at least 12 weeks after therapy completion. sCD163 and sCD14 were measured in serum collected before and after HCV eradication. Results were correlated with changes in markers of hepatic fibrosis.
Mean age of participants was 56.3 years, mean CD4+ cell count was 615, and 72% had suppressed HIV RNA. After treatment, sCD163 and sCD14 levels significantly decreased from pre-treatment levels in unadjusted analyses. After adjusting for age, race, hepatic fibrosis status, baseline HCV RNA, CD4 count and HIV RNA status, cigarette smoking, and alcohol use, the decreases in sCD163 and sCD14 remained significant. Decrease in pre-treatment to post-treatment sCD163 were significantly positively correlated with changes in FIB-4 (r = 0.250, P = 0.005) and APRI (r = 0.262, P = 0.003); similarly decrease in sCD14 was significantly positively correlated with changes in FIB-4 (r = 0.333, P = 0.0001) and APRI (r = 0.457, P < 0.0001).
HCV eradication is associated with significant reductions in monocyte/macrophage activation markers that correlate with reductions in markers of hepatic fibrosis. These findings support broad access to and early initiation of HCV treatment in order to decrease immune activation and improve health in HIV-infected persons.
清除丙型肝炎病毒 (HCV) 可降低 HIV 感染者的肝脏和非肝脏相关发病率和死亡率。单核细胞/巨噬细胞活化的标志物（可溶性 CD163 和 sCD14）升高与 HIV 相关的非艾滋病发病率和死亡率过高有关。我们研究了 HCV 清除对这些标志物的影响与肝纤维化变化的关系。
一项在纵向观察队列内嵌套的子研究。
我们研究了 126 例成功接受 HCV 治疗且治疗结束后至少 12 周 HCV RNA 检测不到的 HIV/HCV 合并感染女性。在 HCV 清除前后采集血清，检测 sCD163 和 sCD14。结果与肝纤维化标志物的变化相关。
参与者的平均年龄为 56.3 岁，平均 CD4+细胞计数为 615，72%的患者 HIV RNA 得到抑制。在未调整分析中，治疗后 sCD163 和 sCD14 水平从治疗前水平显著降低。在校正年龄、种族、肝纤维化状态、基线 HCV RNA、CD4 计数和 HIV RNA 状态、吸烟和饮酒后，sCD163 和 sCD14 的降低仍然具有统计学意义。治疗前到治疗后 sCD163 的降低与 FIB-4（r=0.250，P=0.005）和 APRI（r=0.262，P=0.003）的变化呈显著正相关；同样，sCD14 的降低与 FIB-4（r=0.333，P=0.0001）和 APRI（r=0.457，P<0.0001）的变化呈显著正相关。
HCV 清除与单核细胞/巨噬细胞活化标志物的显著降低相关，这些标志物与肝纤维化标志物的降低相关。这些发现支持广泛获得和早期开始 HCV 治疗，以降低 HIV 感染者的免疫激活并改善健康。
