Nadir CD4 is negatively associated with antinuclear antibody detection in HCV/HIV coinfected patients.

BACKGROUND: HCV and HIV infections are associated with higher risk of autoimmune diseases and T-cell dysfunction.

SETTING: We evaluate prevalence and factors associated with the presence of autoimmune antinuclear (ANA), anti-smooth muscle actin (aSMA) and anti-liver kidney microsomes (aLKM1) antibodies (Ab) in HCV/HIV coinfected patients during the post-cART era.

METHODS: cross-sectional observational study, nested in the ANRS CO13 HEPAVIH cohort (NCT number: NCT03324633). We selected patients with both ANA testing and T-cell immunophenotyping determination during the cohort follow-up and collected aLKM1 and aSMA data when available. Logistic regression models were built to determine factors associated with the presence of auto-Ab.

RESULTS: 223 HCV/HIV coinfected patients fulfilled selection criteria. Prevalence of ANA and aSMA was 43.5% and 23.2%, respectively, and both were detected in 13.3% of patients. Isolated aSMA were detected in 9.9% and aLKM1 in 2 patients. In multivariable analysis, only a low nadir CD4 T-cell count was significantly associated with ANA detection.

CONCLUSION: ANA and aSMA detection remain frequent in HCV/HIV coinfected patients during post-cART era despite fair immune restoration. These results advocate for a close monitoring of ANA before immune checkpoint inhibitor therapy in these patients with greater caution for those with a low nadir CD4 T- cell count.