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Blood, 15 December 2000, Vol. 96, No. 13, pp. 4293-4299
IMMUNOBIOLOGY
Immunologic dynamics in hemophiliac patients infected with
hepatitis C virus and human immunodeficiency virus: influence of
antiretroviral therapy
Shouichi Yokozaki,
Junki Takamatsu,
Isao Nakano,
Yoshiaki Katano,
Hidenori Toyoda,
Kazuhiko Hayashi,
Tetsuo Hayakawa, and
Yoshihide Fukuda
From the Second Department of Internal Medicine and
Department of Transfusion Medicine, Nagoya University, School of
Medicine, Nagoya, Japan.
Infection with hepatitis C virus (HCV) or human immunodeficiency
virus (HIV) or both is common in hemophiliac patients due to putative
transmission through clotting factor concentrates. Recently, highly
active antiretroviral therapy (HAART) has been found to markedly
improve viremia and immunologic parameters in patients infected with
HIV. This report considers interactions between these viral infections,
the immune system, and antiretroviral therapy. A total of 130 male
hemophiliac patients were grouped according to type of viremia (HCV,
HIV, both, or neither). Along with 30 healthy men age-matched to
viremic patients, these groups were compared with respect to viral load
and immunologic parameters. Thirty-five patients treated as above for
HIV were serially followed up. HCV infection was associated with
reduced peripheral B-cell and CD4+-cell counts and with
increased serum IgG and IgM levels, whereas HIV infection was
associated with reduced peripheral CD4+-cell counts and
increased serum IgG and IgA levels. In patients with both
viruses, HCV and HIV RNA load correlated inversely with peripheral
B-cell and CD4+-cell counts, respectively. HAART reduced
levels of both viruses in the blood. Of the 25 patients with both
viruses, HAART eliminated HCV in 2. In conclusion, immunologic dynamics
differed between hemophiliac patients infected with HCV, HIV, or both.
The relative dynamics of HCV viral load, peripheral B-cell count, and
serum IgM level were similar to those of HIV viral load,
CD4+-cell count, and serum IgA.
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