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Chronic Immune Activation among Treatment Naïve HIV/ HBV Coinfected Individuals from Southern India

Author(s):

John Paul Demosthenes, GnanaduraiJohn Fletcher, Uday George Zachariah, George Mannil Varghese, Susanne Alexander Pulimood, Priya Abraham and Rajesh Kannangai*  

Abstract:


Background: Chronic immune activation is one of the most widely recognized hallmarks of HIV infection. T-cells that express CD38+ and HLA-DR+ show poor proliferative potential, signal transduction, and increased apoptotic potential. This affects HIV pathogenesis and its outcome and further complicates with a coinfection like HBV.

Method: Study Design: Cross-sectional. Blood samples were collected and analyzed for virological markers using ELISA for HBeAg and RT-PCR for HIV&HBV Viral load. Chronic immune activation markers of CD8+ and CD4+ T cells were measured by Flow cytometry for both HIV and HBV

Results: There was a significant increase in HBV replication shown by higher HBV DNA (p=0.002), a higher proportion of HBeAg (p=0.0049), and lower CD4 counts (p=0.04) among HIV/HBV coinfected individuals, compared to the monoinfected groups. The frequencies of CD4+ CD38+ HLA-DR+ and CD8+ CD38+ HLA-DR+ in the HIV/HBV coinfection were significantly higher than HBV monoinfected group (P< 0.0001) and in the HIV monoinfected group (P < 0.0001). The Liver fibrosis score APRI and FIB-4, were higher in the coinfected group compared with HBV monoinfected group (0.67 vs 0.25, p = 0.0085; 3.48 vs 0.98, p = 0.0026), respectively. The cytokine levels of IL-17, Fas-L, TNF -α, IL-10, IL-2and Granzyme B were also measured and compared among the study groups.

Conclusion: Our data suggest that HIV probably influences the immune activation of CD4+ and CD8+ T cells, and this may play a significant role in accelerating the disease outcome among HIV/HBV coinfected individuals.

Keywords:

HIV, HBV, HIV/HBV coinfection, Chronic immune activation, liver disease, CD38, HLA-DR

Affiliation:

Department of Clinical Virology, Christian Medical College, Vellore, Tamil Nadu, 632004., Department of Clinical Virology, Christian Medical College, Vellore, Tamil Nadu, 632004., Department of Hepatology, Christian Medical College, Vellore, Tamil Nadu, 632004., Department of Infectious Diseases, Christian Medical College, Vellore, Tamil Nadu, 632004., Department of Dermatology, Christian Medical College, Vellore, Tamil Nadu, 632004. , Department of Clinical Virology, Christian Medical College, Vellore, Tamil Nadu, 632004., Department of Clinical Virology, Christian Medical College, Vellore, Tamil Nadu, 632004.



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