Cirrhosis Depletes CD4 Cells, Even in the Absence of HIV

Absolute CD4-cell counts might not be a reliable means of assessing immunosuppression in HIV-infected patients with advanced liver disease.

In patients coinfected with HIV and hepatitis C virus (HCV), clinicians have sometimes observed that CD4-cell counts are lower than would be expected, given an apparently good virologic response to treatment. Indeed, some studies have suggested that coinfection is a risk factor for impaired immunologic response. This study of CD4-cell counts among HIV-uninfected patients with advanced liver disease sheds further light on the subject.

Sixty HIV-negative patients with cirrhosis (as determined by biopsy or clinical criteria) were prospectively enrolled in this Boston-based study; 31 had HCV infection, and 1 had HBV. Based on Child-Turcotte-Pugh scores, 21 patients had class A cirrhosis, 24 had class B, and 15 had class C. Thirty-nine patients (…

Reviewing Author

Rachel Baden, MD

Cirrhosis Depletes CD4 Cells, Even in the Absence of HIV

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Reviewing Author