WEAX0105 - Oral Abstract Session
HLAB57 does not fully explain the ability of HIV controllers to spontaneously clear hepatitis C virus (HCV) infection
Presented by Alice Asher (United States).
A. Asher1,2, G.-M. Santos1, E.K. Dokubo3, J. Martin4, S. Deeks4, L. Tobler5, M. Busch5, P. Hunt4, K. Page1
1University of California San Francisco, Epidemiology & Biostatistics, San Francisco, United States, 2University of California San Francisco School of Nursing, Community Health Systems, San Francisco, United States, 3University of California San Francisco, Center for AIDS Prevention Studies, San Francisco, United States, 4University of California San Francisco, Positive Health Program, San Francisco, United States, 5Blood Systems Research Institute, San Francisco, United States
controllers, maintaining low plasma HIV RNA levels (< 2000 copies/ml) in the
absence of antiretroviral therapy, are also more likely to spontaneously clear
HCV infection. HLAB57, the major histocompatibility class I gene, is highly
enriched in HIV controllers and is associated with HCV spontaneous clearance.
Whether HLAB57 explains the increased prevalence of spontaneous HCV clearance
observed in HIV controllers remains unclear.
in the Study of the Consequences of Protease Inhibitor Era (SCOPE) were tested
for anti-HCV using enzyme immunoassay (EIA3) and HCV RNA using discriminatory
HCV transcription-mediated amplification assay (Norvatis®). We compared
the proportion of HIV controllers and HIV non-controllers with serological
evidence of HCV clearance (anti-HCV+/RNA-) by chi-square tests
and assessed whether HLAB57 status explains the increased prevalence of HCV
clearance in HIV controllers using adjusted prevalence ratio (APR) with Poisson
Results: Of 279 HIV/HCV seropositive subjects, 48 were HIV controllers. HIV
controllers were significantly more likely to have evidence of spontaneous HCV
clearance than HIV non-controllers (58% vs. 38%, p=0.01). While HIV controllers
were more likely to have HLAB57 than HIV non-controllers, (33% vs. 10%, p<
0.01), HLAB57 was not significantly associated with HCV clearance among all
participants (39% vs. 55% p=0.06), and there was no evidence of increased
prevalence of HCV clearance among HLAB57+ vs. HLAB57- in HIV controllers (p=0.83). In
multivariate analyses adjusted for HLAB57, age, gender, and race/ethnicity, HCV
clearance was significantly more likely in HIV controllers than HIV non-controllers
(APR 1.44; 95% CI 1.04-2.0; p=0.026).
Conclusions: HIV controllers are more likely to spontaneously clear HCV than
HIV-non-controllers even when controlling for HLAB57 status. Immunologic
factors other than HLAB57 must contribute to the control of HIV and HCV in HIV
controllers. Identifying these factors may support the development of novel
treatments for and effective vaccines against both viruses.
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