Deficit deepening of naive T-cells CD4+ in patients with HIV infection when co-infected with hepatitis C virus
Objective. In patients infected with the human immunodeficiency virus (HIV) and co-infected with the hepatitis C virus (HCV), CD4+ T-cell deficiency is more pronounced compared to HIV monoinfected subjects, due to a reduction in their naive subpopulation. This work is devoted to establishing the causes of the development of insufficiency of these cells. Methods. Two groups of HIV-infected persons were examined: HIV+HCV+ (n=21) and HIV+HCV- (n=21) receiving antiretroviral drugs for more than two years (HIV level <50 copies/ml). Anti-HCV therapy was not conducted. The control group (n=20) consisted of uninfected volunteers. The number of naive CD4+ T cells, the proportion of these included RTE (recent thymic emigrants; CD31+), the content of activated CD4+ T-lymphocytes (HLA-DR+ CD38+), the concentration in the blood of bacterial lipopolysac-charide, the activity of transaminases. Results. Immune activation negatively affected the number of naive CD4+ T cells in both groups of HIV-infected. However, only in the HIV+HCV+ group the inverse relationship between the activity of transaminases, on the one hand, and the proportion of RTE on the other hand (R<sub>ALT-RTE</sub> =-0.590, p<0.005 and R<sub>AST-RTE</sub>=-0.468, p<0.05), and also the level of lipopolysaccharide and the number of mature (CD31<sup>-</sup>) naive CD4+ T-lymphocytes (R =-0.535, p<0.02). Conclusions. Thus, hepatitis activity and increased microbial translocation from the intestine in HIV/HCV co-infection may have a negative effect on the number of naive CD4+ T cells. Naive elements of varying degrees of maturity are apparently affected. Specific mechanisms for the formation of a deficit of naive CD4+ T-lymphocytes in HIV/HCV-co-infected individuals have yet to be established.