Effects of HIV infection on the disease progression of hepatitis C in patients with HIV/HCV coinfection
Objective 
To analyze the differentiation status of CTL and to evaluate its clinical value in patients with HIV/HCV coinfection. 
 
 
Methods 
Twenty-eight patients with HIV/HCV coinfection and twelve patients with single HCV infection were enrolled in this study. The technique of Fibro-Scan was used to evaluate liver fibrosis. The viral load of HCV was detected by real-time quantitative PCR. Flow cytometry analysis was performed to measure the differentiation status of CTL. 
 
 
Results 
Both of the levels of alanine transaminase (ALT) and alkaline phosphatase (ALP) in patients with HIV/HCV coinfection were significantly higher than those in patients with single HCV infection [(53.7464±48.1180) U/L vs (27.4750±13.9850) U/L, P=0.012; (24.5071±8.1940) g/L vs (16.9667±7.1890) g/L, P=0.009]. The liver stiffness of patients with HIV/HCV coinfection was higher than that of patients with single HIV infection [(5.9500, 5.8250) Kpa vs (5.1500, 1.0500) Kpa, P=0.117]. Compared with the patients with single HCV infection, the patients with HIV/HCV coinfection showed higher viral loads of HCV [(6.4768, 5.3434) lg copy/ml vs (2.6815, 1.6990) lg copy/ml, P=0.012], but lower clearance rate of HCV [32.14% vs 75%, P=0.032]. Compared with the patients with single HCV infection, the patients with HIV/HCV coinfection showed lower percentages of CD27+ CD28+ CTL [(28.265±15.095)% vs (18.068±10.263)%, P=0.017), but higher percentages of CD27+ /-CD28+ CTL [(62.449±14.561)% vs (71.111±12.681)%, P=0.066]. A trend toward negative correlation was observed between the percentage of CD27+ CD28+ CTL and the degree of liver stiffness (r=-0.310, P=0.058). 
 
 
Conclusion 
HIV infection could accelerate the progression of liver disease in patients with HIV/HCV coinfection by affecting the differentiation of CTL. 
 
 
Key words: 
HIV; HCV; Coinfection; CTL differentiation