A Preliminary Study On The Changes Of The Plasma HCV Viral Load And Epstein-Barr Virus Reactivation In HIV-infected Patients After Highly Active Antiretroviral Therapy In Henan

Human immunodeficiency virus(HIV) and hepatitis C virus(HCV) have same routes of transmission, mainly through blood route. There are many patients of HCV co-infected in HIV-infected patients. HCV-related hepatic disease is common in HIV-infected patients. Most HIV-infected patients have Epstein-Barr virus latent infection. EBV reactivation can lead to some of opportunistic infection and tumor. HIV/HCV coinfection and EBV reactivation make the pathogenetic condition more complicated,and impact the development and prognosis in HIV-infected patientsObjective: part one,to study the rate of HIV/HCV coinfection in HIV infectedpatients in Henan,the changes of immune function and the plasma HCV viral load in HIV/HCV co-infected patients after highly active antiretroviral therapy(HAART).To investigate the impact of immune function and plasma HCV load after HAART. Part two,to investigate the frequency of EBV DNA in peripheral blood mononuclear cells (PBMCs) of HIV-infected patients in Henan to know the state of EBV reactivation in HIV-infected and the influence of HAART to EBV reactivation. METHOD:part onePlasma HCV-IgG was detected with enzyme linked immunosorbent assay(ELISA) in 228 HIV-infected patients in certain county in Henan. In the HIV infected patients of introduction HAART more than 6 months and HCV-IgG positive, according to HIV viral load ,the 57 HIV/HCV co-infected patients were divided into three groups:group A(HIV viral load10~5/10~6copies /ml, n=6), group B(HIV viral Lload10~3/10~4copies /ml) and group C(HIV viral load was not deteced,n=37).HIV/HCV co-infected patients were detected peripheral blood CD4+T cell count with flow cytometry and plasma HIV viral load and HCV viral load with real-time fluorescent quantitative polymerase chain reaction(PCR). The 3 groups were compared on CD4+T cell count, plasma HIV viral load and HCV viral load. HIV viral load and HCV viral load were analyzed the correlation in HIV/HCV co-infected patients after HAART.Part twoEBV DNA fragment was amplified in peripheral blood monouclear cells(PBMCs) in 73 HIV-infected patients as HIV-infected group and 80 healty people as control group with nest PCR. CD4+T cell count and HIV viral load were detected in 73 HIV-infected patients. According to HIV viral load,73 HIV-infected patients were divided into two groups: group D(HIV viral load> 1000 copies /ml, n=25) and group E(HIV viral load was not deteced,n=48). HIV-infected group and control group were compared on the frequency of EBV DNA. Group D and group E were compared on the frequency of EBV DNA and CD4+T cell.RESULT:Part one1. The rate of HCV-IgG positive is 88.6%(202/228) in HIV-infected patients.2. The mean value of CD4+T cell count in group A,B and C were 95.50±76.10cell/ul, 175.64±141.19cell/ul and 241.46±105.97cell/ul ,respectively. There were significant difference in the mean value of CD4+T cell count in the 3 groups (F=5.14, P=0.009).The mean value of CD4+T cell count in group A was significant lower than in group C(P=0.005).3. The mean value of plasma HCV viral load(Log10) in the group A,B and C were 3.97±3.25,3.46±3.17 and 4.21±2.78,respectively.There were no significant difference in the mean value of plasma HCV viral load(Log10in the 3 groups. (F=0.333, P=0.719)4.We analyed the correlation between HIV viral load and HCV viral load in HIV/HCV co-infected patients after HAART. Controlling for CD4+T cell count, coefficient of partial correlation was -0.077(P=0.568).Nor controlling for CD4+T cell count, coefficient of partial correlation was -0.050(P=0.711).HIV viral load and HCV viral load have not correlation.Part two5. The frequency of EBV DNA detection ,in PBMCs of HIV-infected group and control group, were 26/73(35.6%) and 4/80(5.0%), respectively. The frequency of EBV DNA detection in HIV-infected group was significant higher than in control group( x~2=9.858, P=0.002).6.The frequency of EBV DNA detection in group D and group E were 15/25(60.0%) and 11/48(22.9%), respectively. The frequency in group D was significant higher than in group E( x~2=9.858, P=0.002<0.05).7. The mean value of CD4+T cell count in group D and in group E werel47.32±118.58 cell/ul and 231.56±109.79cell/ul,respectively. The mean value of CD4+T cell count in group E was significant higher than in group D( t=3.024, P=0.003< 0.05).CONCLUSION:Part one1. In HIV-infected patients transmitted with blood route, the rate of HIV/HCV coinfected was very high in Henan.2. HAART was not able to eliminate or reduce the HCV viremia but able to restore immune function in HIV/HCV co-infected patients.3. There was no directly impaction between HIV and HCV in HIV/HCV co-infected patients. Part two4. The prevalence of EBV reactivation in HIV-infected patients was also higher than in healthy people.5. EBV reactivation significantly decreased in HIV infected patients who received effective HAART ,and the reduction of EBV reactivation was possibly associated with the increase of CD4+ T cell count in HIV-infected patients.