Despite successful HIV suppression by antiretroviral treatment (ART), immune activation may persist in HIV patients, contributing to an impaired immunological reconstitution and disease progression. Information regarding Hepatitis C virus (HCV) coinfection as a factor that accounts for immune activation in HIV subjects remains unclear. Furthermore, most studies have been carried out considering HIV/HCV patients as a whole, without taking into account the presence or absence of liver damage. Therefore, it is unknown if HCV and/or its liver-related disease could act as two independent factors contributing to the immune activation. In this study, we investigated the presence of immune activation in a cohort of 50 HIV/HCV patients by measuring cytokine levels, CD4⁺ T-cell counts and CD4/CD8 ratios. Six patient groups were defined according to HIV viral load, HCV status, and liver disease to assess the impact of each of these factors on immune activation and reconstitution in HIV/HCV patients. Only subjects with controlled HIV infection and cleared HCV displayed immunological parameters within normal ranges. The mere presence of HCV contributes to immune activation leading to an inappropriate immunological reconstitution. This state exacerbates in the presence of HCV-associated liver disease. Our results suggest that ART is not enough to suppress immune activation in the context of HIV/HCV coinfection, since both HCV and its liver-related disease would contribute to the immune activation. Given that immune activation worsens immunological reconstitution and clinical status, these results support the priority of HCV treatment in HIV/HCV patients and suggest the monitoring of their liver status.

中文翻译：

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丙型肝炎病毒共感染对HIV受试者免疫重建的影响。

尽管通过抗逆转录病毒治疗（ART）成功抑制了HIV，但免疫活化仍可能在HIV患者中持续存在，从而导致免疫重建和疾病进展受损。关于丙型肝炎病毒（HCV）合并感染是导致HIV受试者免疫激活的因素的信息尚不清楚。此外，大多数研究都是从整体上考虑HIV / HCV患者，而不考虑是否存在肝损伤。因此，尚不清楚HCV和/或其肝脏相关疾病是否可以作为促成免疫激活的两个独立因素。在这项研究中，我们通过测量细胞因子CD4 ^+的水平，调查了50名HIV / HCV患者队列中免疫激活的存在。T细胞计数和CD4 / CD8比率。根据HIV病毒载量，HCV状况和肝病定义了六个患者组，以评估这些因素对HIV / HCV患者免疫激活和重建的影响。只有控制HIV感染和清除HCV的受试者显示出正常范围内的免疫学参数。HCV的单纯存在会导致免疫激活，导致不适当的免疫重建。在存在HCV相关肝病的情况下，这种状态会恶化。我们的结果表明，在HIV / HCV合并感染的情况下，ART不足以抑制免疫激活，因为HCV及其与肝脏相关的疾病都将有助于免疫激活。鉴于免疫激活会使免疫重建和临床状况恶化，