Document Detail


Biomarkers of inflammation and coagulation are associated with mortality and hepatitis flares in persons coinfected with HIV and hepatitis viruses.
MedLine Citation:
PMID:  23335804     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hepatitis C virus (HCV) and/or hepatitis B virus (HBV) coinfection with human immunodeficiency virus (HIV) has a greater risk of mortality than either HCV or HBV infection alone and is frequently associated with hepatitis flares after antiretroviral therapy (ART) initiation.
METHODS: We performed a retrospective cohort study of 287 HIV-positive persons coinfected with HBV and/or HCV (70 had HBV coinfection only, 207 had HCV coninfection only, and 10 had HBV and HCV coinfections) who had pre-ART plasma samples evaluated for biomarkers associated with death (within 4 years) and/or hepatitis flare (within 4 months) after ART initiation. A predictive biomarker risk score was calculated.
RESULTS: Forty-eight deaths and 50 hepatitis flares occurred. Nonsurvivors were older, had more prior AIDS-defining events, and had higher pre-ART triglycerides and aspartate transaminase levels. Detectable hyaluronic acid and higher d-dimer, interleukin 6, interleukin 8, and soluble CD14 levels were associated with death in univariate models and with a composite biomarker risk score. The risk of hepatitis flares was higher with HBV coinfection only (24.3%) and with HBV and HCV coinfection (50%) than with HCV coinfection only (13.5%). Higher levels of alanine transaminase and interleukin 10 were also associated with hepatitis flares.
CONCLUSIONS: Among HIV-positive patients coinfected with HBV and/or HCV who are initiating ART, biomarkers of inflammation and coagulation are associated with an increased risk of death, whereas HBV coinfection and higher pre-ART interleukin 10 levels are associated with hepatitis flares.
Authors:
Bruno Bezerril Andrade; Katherine Huppler Hullsiek; David R Boulware; Adam Rupert; Martyn A French; Kiat Ruxrungtham; Marisa Luisa Montes; Huw Price; Pablo Barreiro; Jennifer Audsley; Alan Sher; Sharon R Lewin; Irini Sereti;
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, N.I.H., Intramural; Research Support, Non-U.S. Gov't     Date:  2013-01-18
Journal Detail:
Title:  The Journal of infectious diseases     Volume:  207     ISSN:  1537-6613     ISO Abbreviation:  J. Infect. Dis.     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-03-29     Completed Date:  2013-05-22     Revised Date:  2014-05-07    
Medline Journal Info:
Nlm Unique ID:  0413675     Medline TA:  J Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1379-88     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Retroviral Agents / administration & dosage
Biological Markers / blood*
Blood Coagulation Disorders*
Cohort Studies
Female
HIV Infections / complications*,  drug therapy,  mortality
Hepatitis B / diagnosis,  mortality*,  pathology*
Hepatitis C / diagnosis,  mortality*,  pathology*
Humans
Inflammation
Male
Middle Aged
Prognosis
Retrospective Studies
Survival Analysis
Grant Support
ID/Acronym/Agency:
3 U01AI068641-05S1/AI/NIAID NIH HHS; K23 AI073192/AI/NIAID NIH HHS; U01AI042170/AI/NIAID NIH HHS; U01AI046362/AI/NIAID NIH HHS
Chemical
Reg. No./Substance:
0/Anti-Retroviral Agents; 0/Biological Markers
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