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The article presents a study on persistent abnormalities in peripheral blood dendritic cells and monocytes from human immunodeficiency virus (HIV)-1-positive patients after one year of antiretroviral therapy (ART) in the U.S. The subjects were tested before therapy and after a number of weeks after starting ART. The results of the study show an incomplete T-cell immune reconstitution in chronically infected patients who had undetectable plasma viremia while taking ART for 1 year.

Background: Low baseline serum hepatitis C virus (HCV)-RNA and clearance of viraemia at week 4 with pegylated interferon (pegIFN) plus ribavirin therapy predict sustained virological response (SVR) and enable a shorter duration of therapy in patients with chronic hepatitis C. It is unclear whether this applies to HIV/HCV-co-infected patients., Patients and Methods: In the Peginterferon Ribavirin ESpaña COinfection (PRESCO) trial, 389 co-infected patients received pegIFN-alpha2a 180 microg/week plus ribavirin 1000-1200 mg/day. Patients with HCV-2/3 were treated for 6 or 12 months, whereas patients with HCV-1/4 were treated for 12 or 18 months. For each genotype, baseline HCV-RNA and rapid virological response (RVR), defined as under 50 IU/ml HCV-RNA at week 4, were evaluated as predictors of SVR in an 'on-treatment' analysis., Results: Overall, SVR was achieved by 193 patients (49.6%), 68/191 (35.6%) with genotype 1, 110/152 (72.4%) with genotypes 2/3 and 15/46 (32.6%) with genotype 4. RVR was the best predictor of SVR regardless of HCV genotype. Only for HCV-1 patients, baseline HCV-RNA less than 500 000 IU/ml was also associated with SVR. In HCV-3 patients RVR had a positive predictive value (PPV) for SVR of 90%, with treatment for 24 or 48 weeks. The PPV of SVR for patients with RVR was 69% for HCV-1 and 83% for HCV-4., Conclusion: Undetectable HCV-RNA at week 4 is the best predictor of curing chronic hepatitis C in HCV/HIV-co-infected patients. In HCV-1 patients, baseline HCV-RNA also predicts response. HIV patients with HCV-3 and RVR may permit shortening therapy duration to only 24 weeks of pegIFN plus 1000-1200 mg ribavirin.

Objectives: To analyse the distribution, expression of chemokine receptors and ex vivo production of inflammatory cytokines by peripheral blood (PB) monocytes and DC in HIV-1+ individuals., Design: Dendritic cells (DC) play an important role in the establishment and dissemination of HIV infection. DC interaction with HIV depends on expression of HIV receptors and co-receptors. Accumulating evidence supports the notion that DC functionality is impaired in HIV-1+ patients., Methods: PB samples from 30 naive-treated HIV-1+ progressors were studied. Additionally, 10 adult healthy volunteers (AHV), seven Hepatitis C virus positive (HCV+)/HIV-1- patients and five long-term non-progressor HIV-1+ patients (HIV-1+LTNP) were included as controls. Flow cytometry immunophenotyping was used for the identification, enumeration and characterization of monocytes and DC., Results: PB myeloid DC (mDC) and plasmacytoid DC (pDC) were significantly decreased in HIV-1+ progressors, while unaltered in HIV-1+LTNP. The expression of CXCR2 and CXCR4 and of CXCR4 and CCR5 were severely altered on PB mDC and pDC from HIV-1+ progressors, respectively. By contrast, both the expression of the chemokine receptors analysed and the numbers of CD16+ DC in HIV-1+ progressors were not different from AHV, while altered in HCV+/HIV-1- and HIV-1+LTNP. Furthermore, PB monocytes and DC from HIV-1+ progressors spontaneously produced inflammatory cytokines, in contrast with AHV., Conclusions: These results support the existence of a selective interaction between HIV-1 and both mDC and pDC, associated with HCV co-infection-independent spontaneous production of inflammatory cytokines, reflecting the occurrence of in vivo activation of the immune system, which might further contribute to the impaired DC functionality.