Influence of Directly Acting Antiviral Therapy of Hepatitis C on the Course of HIV Infection in Patients with HIV and HCV co-Infection
Purpose. To assess the effect of therapy with direct acting antiviral drugs (DAADs) for hepatitis C in patients with HIV/HCV co-infection on the course of HIV infection. Materials and methods. A comparative analysis of clinical and laboratory data in 2 groups of patients was carried out: group 1 - 63 patients with HIV co-infection and HCV infection who received DAAD therapy and group 2 - 61 patients with HIV / HCV co-infection who did not receive antiviral therapy for HCV. 62 (98.4%) patients in the 1st group received DAADs sofosbuvir + daclatosvir lasting 12 weeks, 1 patient received a sofosbuvir + daclatosvir + ribavirin regimen lasting 24 weeks. In 61 (96.8%) patients in the 1st group, SVR was achieved. The clinical data of the patients, the results of the immunogram, and the HIV viral load (VL) indicators taken twice were evaluated in the 1st observation group: before the start of the DAADs treatment and after the completion of the DAADs therapy, Median (Me) the time period was 6 months. In the second group of patients, the parameters of the immunogram and HIV VL were evaluated over the same period of time, Me was 6 months (p>0.05). Results. In patients of the 1st group after DAADs, a significant increase in CD4 + T-lymphocytes (cells/μL) was established compared with the initial level: 452 (274; 677) vs. 410 (226; 611), respectively, p<0.01, Sign test; decrease in CD8+ T-lymphocytes (%): 50 (38; 59) vs. 55 (46; 55),p<0.01; an increase in the immunoregulatory index (IRI): 0.51 (0.31; 1.14) vs. 0.47 (0.26; 0.76), p<0.01;reduction in VL HIV (kop/ml): less than 500 (<500; 12 000) vs. 534 (<500; 34 000), p<0.01. In the second group of patients, there was no significant change in the indices of CD4 + T-lymphocytes (p>0.05). Also, an increase in CD8+ T-lymphocytes (%): 57 (48; 67) vs. 55 (46; 55), p<0.01; IRI decrease:0.35 (0.2; 0.51) vs. 0.37 (0.21; 0.63), p<0.01; VL HIV did not decrease (kop/ml): 2400 (<500; 45 000)vs.1600 (<500; 52 000), p>0.05 were observed over studied term in the 2nd group.Conclusions. Receiving of DAADs in patients with HIV and HCV co-infections was associated with beneficial effect on the course of concomitant HIV infection in result of the restoration of the immune system, as against the background of therapy, patients showed an increase in CD4+ T lymphocytes, a decrease in the content of CD8+ T lymphocytes, an increase in IRI, and a decrease in the level of HIV viral load.