Program Schedule

1562
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.

 

Parameter

HIV+/HCV-

HIV+/HCV+

P-value

CD4

Absolute Δ*

199.0 (115.0-342.0)

162.0 (79.0-237.0)

0.15

% Δ**

98.8 (39.3-189.0)

64.6 (33.0-177.8)

0.20

B-cell

Absolute Δ

84.3 (22.6-200.4)

90.7 (15.1-201.7)

0.98

% Δ

81.0 (24.6-203.8)

88.6 (5.3-233.9)

0.98

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

Disclosures:

M. S. Abers, None

Z. Afzal, None

J. E. Weatherhead, None

C. G. Minard, None

M. C. Rodriguez-Barradas, None

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