938. Immune Marker Differences and Changes in HCV monoinfected and HIV Co-infected Patients
Session: Poster Abstract Session: Biomarkers and Risk Factors for Viral Infections
Saturday, October 22, 2011
Room: Poster Hall B1
Background:  

Cytokines such as IFN-α, IFN-γ, IL-6, IL-8, IL-10, and TNF-α are correlated with HCV treatment response and fibrosis in HCV-infected patients. Various inflammatory markers and cytokines are implicated in the accelerated pathogenesis of various comorbidities based primarily on HIV or HCV monoinfected cohorts, though only D-dimer and C-reactive protein have been consistently studied.  Few, smaller studies have evaluated HCV/HIV co-infected patients and there is little longitudinal data describing a broader cytokine response in HCV infection and the impact of HIV or HCV treatment in this response. We quantified and evaluated a broader spectrum of previously-studied and unstudied cytokines, based on HIV co-infection status and HCV treatment response.

Methods:  

50 plasma immune markers were analyzed using the Luminex 50-plex assay at baseline (BL) and at end of treatment response (ETR) from 24 HCV (predominantly genotype 1) monoinfected and 49 HCV/HIV infected patients receiving antiretroviral treatment, who either did or did not receive peg-interferon/ribavirin treatment. BL levels were compared between mono- vs. co-infected; and co-infected HCV sustained virologic responders (SVR, n=18) vs. nonresponders (NR, n=20) at BL and ETR using nonparametric analyses with significant differences defined as P < 0.05.

Results:  

When comparing HCV patients to HCV/HIV patients, the HCV patients had significantly lower BL levels to 22 cytokines, but had significantly higher BL levels to 9 cytokines. When restricting to co-infected patients, there were no significantly different BL levels for 48 of the 50 markers tested (all except MIG and IL-17F) between SVR and NR.  However, while there was no significant change in levels to all 50 markers among NR, there was a significant decrease to 13 markers and an increase in 13 markers among SVR. At ETR, 12 markers were significantly increased and 9 decreased comparing SVR to NR.

Conclusion: Clear differences exist in both pattern and quantity of plasma immune markers between HCV mono- and HIV co-infected patients, and HCV treatment response in HIV co-infected patients. These findings may have important predictive value in HCV outcomes, as well as implications for HCV pathogenesis and future therapeutic targets.


Subject Category: V. Virology including clinical and basic studies of viral infections, including hepatitis

Lauren Kushner, BA1, Aaron Wendelboe, Ph.D.2, Aarthi Chary, MD3, Mark Winters, MS4, Anu Osinusi, MD, MPH5, Shyam Kottilil, MD, PhD6, Michael Polis, MD6 and Mark Holodniy, MD7, (1)VA Palo Alto Health Care System, Palo Alto, CA, (2)Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, (3)VA Palo Alto Health Care System, Stanford, CA, (4)Stanford University, Stanford, CA, (5)Infectious Diseases, University of Maryland, Baltimore, MD, (6)LIR/NIAID/NIH, Bethesda, MD, (7)Department of Veterans Affairs, Palo Alto, CA

Disclosures:

L. Kushner, None

A. Wendelboe, None

A. Chary, None

M. Winters, None

A. Osinusi, None

S. Kottilil, None

M. Polis, None

M. Holodniy, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.