Program Schedule

The Influence of Co-infection with HCV on CD4 and B-cell Reconstitution in Human Immunodeficiency Virus (HIV)-infected Patients

Session: Poster Abstract Session: HIV Treatment: Outcomes, Adherence, and Toxicities
Saturday, October 11, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Background:  HIV is associated with dysfunctional cellular and humoral immunity. The effects of co-infection with hepatitis C virus (HCV) on immune reconstitution are controversial. The utility of monitoring B-cell lymphocyte counts in HIV patients has not been well studied. In the present study, we compare the effect of antiretroviral therapy (ART) on CD4 and B-cell counts in HIV mono-infected (HIV+/HCV-) and HCV co-infected (HIV+/HCV+) patients.

Methods: Retrospective observational cohort of 160 HIV-infected patients (39 with HCV co-infection) who suppressed plasma viral load (VL) to undetectable levels within one-year of ART initiation. We reviewed baseline clinical and demographic variables, and CD4 and B-cell counts at two time points: prior to ART initiation and after 9-15 months of persistently undetectable VL (post-ART).  A multiple general linear regression model was used to test for significant associations between predictor variables and change in B-cell counts after adjusting for pre-ART levels as well as covariates significant in the univariate analysis. 

Results: The median absolute pre- to post-ART increase in CD4 and B-cell counts did not differ significantly between the 2 groups (see Table). In HIV+/HCV- and HIV+/HCV+ patients, the % increase in B-cell and CD4 count were strongly correlated (Spearman’s R 0.58 and R 0.65, respectively, P<0.001). In a multiple regression model adjusting for pre-ART B-cell count, HCV-co-infected patients experienced a not statistically significant 15% greater rise in B-cell counts, compared to mono-infected group (P = 0.08).

Conclusion: In this cohort of patients with 9-15 months of suppressed viremia after ART initiation, HCV co-infection did not significantly influence the magnitude of reconstitution of CD4 or B cell counts. Changes in B-cell and CD4 count were strongly correlated. Our data provide support to recent guidelines against routine monitoring of B cell counts.







Absolute Δ*

199.0 (115.0-342.0)

162.0 (79.0-237.0)


% Δ**

98.8 (39.3-189.0)

64.6 (33.0-177.8)



Absolute Δ

84.3 (22.6-200.4)

90.7 (15.1-201.7)


% Δ

81.0 (24.6-203.8)

88.6 (5.3-233.9)


Median increase (IQR); cells/mL plasma; **% increase from pre-ART count

Table 1. CD4 and B-cell increases after 9-15 months of persistently undetectable VL

Michael S. Abers, BA1, Zeeshan Afzal, MD1,2, Jill E. Weatherhead, MD1, Charles G. Minard, Ph.D1 and Maria C. Rodriguez-Barradas, MD1,2, (1)Baylor College of Medicine, Houston, TX, (2)Infectious Diseases and Medicine, Michael E. DeBakey VA Medical Center, Houston, TX


M. S. Abers, None

Z. Afzal, None

J. E. Weatherhead, None

C. G. Minard, None

M. C. Rodriguez-Barradas, None

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