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Gonzalez-Serna A, Corma-Gomez A, Tellez F, García-Martin S, Rivero-Juarez A, Frias M, Vera-Méndez FJ, De Los Santos I, Merino D, Morano L, Imaz A, Galera C, Serrano M, Macias J, Pineda JA. Liver stiffness change with HCV cure in HIV-infected patients on non-nucleoside analogues. J Antimicrob Chemother 2021; 76:2375-2379. [PMID: 34021755 DOI: 10.1093/jac/dkab157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 04/23/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Liver stiffness (LS) at sustained viral response (SVR) is strongly associated with a lower incidence of subsequent hepatic events. HIV NNRTIs may have a beneficial impact on fibrogenesis. OBJECTIVES Our aim was to analyse the influence of NNRTI-based therapy on the change in LS from starting direct-acting antiviral (DAA) therapy to achieving SVR in HIV/HCV-coinfected patients. METHODS Three hundred and thirteen HIV/HCV-coinfected patients who fulfilled the following criteria were included: (i) had achieved SVR with an IFN-free, DAA-including regimen; (ii) LS ≥9.5 kPa before therapy; (iii) LS measurement available at SVR; (iv) seronegative for HBsAg; and (v) ART containing 2 NRTIs plus either 1 NNRTI or 1 integrase inhibitor (INI) or 1-2 NRTIs plus 1 PI. LS changes were assessed. RESULTS Seventy-four patients received NNRTI-based combinations [53 (71.6%) rilpivirine and 16 (21.6%) efavirenz] and 239 patients received other regimens. At baseline, the median (IQR) LS was 16.7 kPa (11.8-25.6) in the NNRTI group and 17.3 kPa (11.9-27.4) in the non-NNRTI group (P = 0.278). The median (IQR) percentage of LS decrease from baseline to SVR was 35.2% (18.2%-52.3%) for NNRTI-based therapy and 29.5% (10%-45.9%) for PI- or INI-based therapy (P = 0.018). In multivariate analysis, adjusted for sex, age, HCV genotype, NRTI backbone and propensity score for HIV therapy, NNRTI-based regimen use was associated with a higher LS decrease [β = 11.088 (95% CI = 1.67-20.51); P = 0.021]. CONCLUSIONS Treatment with NNRTI plus 2 NRTI combinations is associated with a higher LS decline than other ART combinations in HIV/HCV-coinfected patients receiving DAA-based therapy.
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Affiliation(s)
- A Gonzalez-Serna
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Seville, Spain
| | - A Corma-Gomez
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Seville, Spain
| | - F Tellez
- UGC Enfermedades Infecciosas, Hospital Universitario de Puerto Real, Departamento de Medicina, Universidad de Cádiz, Cádiz, Spain
| | - S García-Martin
- UGC Unidad Gestión Clínica de Microbiología, Hospital Universitario de Puerto Real, Cádiz, Spain
| | - A Rivero-Juarez
- Unit of Infectious Diseases, Hospital Universitario Reina Sofia, Instituto Maimonides de Investigación Biomedica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Córdoba, Spain
| | - M Frias
- Unit of Infectious Diseases, Hospital Universitario Reina Sofia, Instituto Maimonides de Investigación Biomedica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Córdoba, Spain
| | - F J Vera-Méndez
- Hospital General Universitario Santa Lucía, Cartagena, Spain
| | - I De Los Santos
- Unit of Internal Medicine and Infectious Diseases, Hospital La Princesa, Madrid, Spain
| | - D Merino
- Unit of Infectious Diseases, Hospital Juan Ramón Jiménez, Huelva, Spain
| | - L Morano
- Unit of Infectious Pathology, Hospital Universitario Alvaro Cunqueiro, Vigo, Spain
| | - A Imaz
- HIV and STI Unit, Department of Infectious Diseases, Hospital Universitario de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - C Galera
- HIV and STI Unit, Internal Medicine Department, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - M Serrano
- Hospital Universitario de Gran Canaria Dr Negrin, Las Palmas, Gran Canaria, Spain
| | - J Macias
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Seville, Spain
| | - J A Pineda
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Seville, Spain
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Martín-Moreno A, Jiménez Blanco JL, Mosher J, Swanson DR, García Fernández JM, Sharma A, Ceña V, Muñoz-Fernández MA. Nanoparticle-Delivered HIV Peptides to Dendritic Cells a Promising Approach to Generate a Therapeutic Vaccine. Pharmaceutics 2020; 12:pharmaceutics12070656. [PMID: 32664555 PMCID: PMC7407655 DOI: 10.3390/pharmaceutics12070656] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/04/2020] [Accepted: 07/06/2020] [Indexed: 01/21/2023] Open
Abstract
Finding a functional cure for HIV-1 infection will markedly decrease the social and economic burden of this disease. In this work, we have taken advantage of the antigen presenting cell role of human dendritic cells (DCs) to try to induce an immune response to HIV-derived peptide delivered to DCs using two different polycationic nanoparticles: a G4 PAMAM dendrimer modified to a 70/30 ratio of hydroxyl groups/amines and a cyclodextrin derivative. We have studied peptide delivery using a fluorescence peptide and have studied the immune response generation by cytokine determination and flow cytometry. We have found a robust delivery of the antigenic peptide to DCs and activated dendritic cell-mediated peripheral blood mononuclear cells (PBMCs) proliferation using the mixed lymphocyte reaction. However, no expression of markers indicating activation of either B or T lymphocytes was observed. Moreover, the release of the pro-inflammatory cytokine TNF-α or IL-2 was only observed when DCs treated with either the dendrimer or the dendriplex containing the peptide. Antigenic peptide delivery to DCs is a promising approach to generate a vaccine against HIV-1 infection. However, more studies, including the simultaneous delivery of several antigenic peptides from different viral proteins, can markedly improve the immune response.
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Affiliation(s)
- Alba Martín-Moreno
- Section of Immunology, ImmunoBiology Molecular Laboratory, Spanish HIV HGM BioBank, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain;
| | - José L. Jiménez Blanco
- Department of. Química Orgánica, Facultad de Química, Universidad de Sevilla, 41012 Sevilla, Spain;
| | - Jamie Mosher
- Department of Chemistry & Biochemistry, Central Michigan University, Mount Pleasant, MI 48859, USA; (J.M.); (D.R.S.); (A.S.)
| | - Douglas R. Swanson
- Department of Chemistry & Biochemistry, Central Michigan University, Mount Pleasant, MI 48859, USA; (J.M.); (D.R.S.); (A.S.)
| | | | - Ajit Sharma
- Department of Chemistry & Biochemistry, Central Michigan University, Mount Pleasant, MI 48859, USA; (J.M.); (D.R.S.); (A.S.)
| | - Valentín Ceña
- CIBERNED, Instituto de Salud Carlos III, 28031 Madrid, Spain;
- Unidad Asociada Neurodeath, Facultad de Medicina, Universidad de Castilla-La Mancha, 02006 Albacete, Spain
| | - María Angeles Muñoz-Fernández
- Section of Immunology, ImmunoBiology Molecular Laboratory, Spanish HIV HGM BioBank, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain;
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Instituto de Salud Carlos III, 28034 Madrid, Spain
- Correspondence: or
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IL-7-induced proliferation of peripheral Th17 cells is impaired in HAART-controlled HIV infection. AIDS 2019; 33:985-991. [PMID: 30946152 DOI: 10.1097/qad.0000000000002164] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Th17 cells are key regulators of functional immunity in mucosal tissues, including the gut-associated lymphoid tissue (GALT), an important site of immune impairment in HIV infection. During HIV infection, Th17 cells are lost in large numbers from the GALT. Despite the recovery of peripheral CD4 T cells that accompanies suppression of viral replication with HAART, Th17 cells in GALT are not completely restored. IL-7 is essential for the survival and proliferation of T cells, but its signaling through its receptor IL-7Rα (CD127), is impaired in CD8 T cells and thymocytes during HIV infection. We set out to determine if decreased CD127 expression or impaired CD127 signaling may be the cause of Th17 impairment in HAART-controlled HIV infection. DESIGN Healthy and HIV donors on HAART were selected for this study of Th17 cell function in HIV. METHODS Peripheral CD4 T cells and Th17 cells were isolated using magnetic beads, then stimulated with IL-7. CD127 expression and the phosphorylation of signaling molecules was determined using flow cytometry. Proliferation was determined with a CFSE dilution assay. RESULTS CD127 was not decreased on Th17 cells from HAART-controlled HIV individuals, in fact, the percentage of Th17 cells that express CD127 was increased in treated HIV individuals. Furthermore, Th17 cells from HAART-controlled individuals, have normal IL-7-induced STAT5 and Bcl-2 responses, but vastly decreased proliferative responses. CONCLUSION This reduced IL-7 responsiveness may explain the lack of Th17 cell recovery and ongoing systemic immune activation that persists despite well treated HIV infection.
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Improved CD4 T cell profile in HIV-infected subjects on maraviroc-containing therapy is associated with better responsiveness to HBV vaccination. J Transl Med 2018; 16:238. [PMID: 30157873 PMCID: PMC6116502 DOI: 10.1186/s12967-018-1617-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 08/23/2018] [Indexed: 12/30/2022] Open
Abstract
Background Maraviroc-containing combined antiretroviral therapy (MVC-cART) improved the response to the hepatitis B virus (HBV) vaccine in HIV-infected subjects younger than 50 years old. We aimed here to explore the effect of this antiretroviral therapy on different immunological parameters that could account for this effect. Methods We analysed baseline samples of vaccinated subjects under 50 years old (n = 41). We characterized the maturational subsets and the expression of activation, senescence and prone-to-apoptosis markers on CD4 T-cells; we also quantified T-regulatory cells (Treg) and dendritic cell (DC) subsets. We used binary logistic regression to evaluate the immunological impact of MVC-cART, correlation with MVC exposure and linear regression for association with the magnitude of the HBV vaccine response. Results HIV-infected subjects on MVC-cART prior to vaccination showed increased recent thymic emigrants levels and reduced myeloid-DC levels. A longer exposure to MVC-cART was associated with lower frequencies of Tregs and activated and proliferating CD4 T-cells. Furthermore, the frequencies of activated and proliferating CD4 T-cells were inversely associated with the magnitude of the HBV vaccine response. Conclusion The beneficial effect of MVC-cART in the HBV vaccine response in subjects below 50 years old could be partially mediated by its reducing effect on the frequencies of activated and proliferating CD4 T-cells prior to vaccination. Electronic supplementary material The online version of this article (10.1186/s12967-018-1617-1) contains supplementary material, which is available to authorized users.
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