Lymphocyte subsets in hemophilic patients with hepatitis C virus infection with or without human immunodeficiency virus co-infection: a nested cross-sectional study

The relationship between HCV infection and lymphocyte subpopulations was evaluated rigorously in 120 asymptomatic hemophilic patients, randomly selected from a prospective cohort study. CD4+ T cells, CD8+ T cells, CD19+ B cells, and CD56+ NK cells were quantified by flow cytometry using cryopreserved peripheral blood mononuclear cells of 24 hemophilic patients in each of five age-matched groups [uninfected; chronic HCV with or without human immunodeficiency virus (HIV); and cleared HCV with or without HIV].As expected, patients with HIV had significantly reduced CD4+ and increased CD8+ T cells. Irrespective of HIV, patients with chronic HCV infection had approximately 25% fewer CD19+ B cells than those without chronic HCV infection.These data support the hypothesis that asymptomatic patients with chronic HCV infection have an altered B-lymphocyte population.The natural history of hepatic C virus (HCV) infection may include B-cell diseases. HCV can be detected in peripheral blood mononuclear cells (PBMCs) and may also replicate in these cells [1-3]. Type II cryogloblinemia and some non-Hodgkin lymphomas have been linked to HCV [4], but links between B cells and asymptomatic HCV infection are poorly defined.One study reported that hemophilic patients co-infected with HCV and human immunodeficiency virus (HIV) had reduced B cells and CD4+ T cells [5]. To further characterize PBMC immunophenotypes in patients with chronic or cleared HCV infection, we quantified proportions of CD4+ T cells, CD8+ T cells, B cells, and natural killer (NK) cells in PBMCs of carefully selected, well characterized hemophilic patients.Patients with hemophilia or another congenital coagulation disorder (herein referred to as "hemophilia") enrolled in the Multicenter Hemophilia Cohort Study [6,7] were categorized into five groups: no HIV or HCV infection (HIV-/HCV-); chronic (viremic) HCV infection without HIV (HIV-/HCV RNA+); chronic (viremic) HCV infection with HIV (HIV+/HCV RNA+); cleared (no