Patients with

PD0332991 mouse HCV infection with and without fibrosis were similar apart from the level of HCV-RNA (Table 1). The group of co-infected patients varied in gender distribution and age compared with HCV-infected patients and healthy controls (P < 0.05) (Table 1). The CD4+ count was as expected significantly lower in patients with HIV co-infection (P < 0.05). The distribution of HCV genotypes was comparable in the three hepatitis groups, and significant associations between genotype, ALT, HCV-RNA and fibrosis were not found (data not shown). According to our definition of fibrosis and cirrhosis, 12 of the 25 HCV-infected patients with a liver stiffness above 8 kPa had a fibroscan defined as cirrhosis. However, no difference in any aspects was found between HCV-infected LY2835219 price patients with fibrosis and cirrhosis (data not shown). To evaluate chronic immune activation, the frequency of activated T cells (CD38+ HLA-DR+) within the CD4+ as well as the CD8+ compartment were determined. The median frequency of both CD4+- and CD8+-activated T cells were elevated in HIV/HCV co-infected patients (2.2%; 1.4–2.6 and 7.0%; 4.1–9.2, respectively), compared with HCV-infected patients

without fibrosis (1.5%; 1.1–1.9, P = 0.03 and 3.4%; 2.1–8.7, P = 0.03), and healthy controls (1.3%; 1.1–1.7, P = 0.01 and 3.5%; 2.5–4.1, P < 0.001) (Fig. 2). There were no differences in activated CD4+ and CD8+ T cells between the two groups of mono-infected

patients and the healthy controls (Fig. 2). CD4+ Tregs, CD8+ Tregs and Th17 cells were determined to evaluate the composition of pro- and anti-inflammatory Glutathione peroxidase lymphocyte subsets. Patients with HCV infection with fibrosis (5.0%; 4.5–5.6) as well as without fibrosis (5.6%; 4.2–6.4) had significantly higher frequencies of CD4+ Tregs compared to healthy controls (4.4%; 3.4–4.7, P = 0.03 and P < 0.001, respectively) (Fig. 3A). Furthermore, the HIV/HCV co-infected patients appeared with even higher frequencies of CD4+ Tregs (6.5%; 6.0–7.0) compared with HCV-infected patients without fibrosis (P = 0.01) and to healthy controls (P < 0.001). To further describe the composition of CD4+ Tregs, three CD4+ Tregs subpopulations were determined based on co-expression of CD45RA and Foxp3 (Fig. 1). HCV-infected patients with fibrosis and HCV infected without fibrosis as well as HIV/HCV co-infected patients had significantly lower frequencies of resting Tregs compared with healthy controls (P < 0.001, P = 0.001 and P = 0.005, respectively) (Fig. 4A). No difference was observed between the three groups of patients. In contrast, the frequency of activated Tregs was higher in both HCV-infected patients and HIV/HCV co-infected patients compared with healthy controls, although, significant difference was only observed when comparing HCV-infected patients without fibrosis and healthy controls (P = 0.022) (Fig. 4B).