TY - JOUR
T1 - Biomarkers of inflammation and coagulation are associated with mortality and hepatitis flares in persons coinfected with HIV and hepatitis viruses
AU - Andrade, Bruno Bezerril
AU - Hullsiek, Katherine Huppler
AU - Boulware, David R.
AU - Rupert, Adam
AU - French, Martyn A.
AU - Ruxrungtham, Kiat
AU - Montes, Marisa Luisa
AU - Price, Huw
AU - Barreiro, Pablo
AU - Audsley, Jennifer
AU - Sher, Alan
AU - Lewin, Sharon R.
AU - Sereti, Irini
N1 - Funding Information:
Financial support. This work was supported in part by the National Institute of Allergy and Infectious Diseases (NIAID; grants 3 U01 AI068641-05S1, U01AI042170, and U01AI046362) and the NIAID Intramural Research Program, National Institutes of Health; the National Research University Project of CHE and the Ratchadaphiseksomphot Endowment Fund, Thailand (grant HR1161A to K. R.); the National Science and Technology Development Agency, BIOTEC (grant to K. R.); and the Thai Research Fund, Thailand (to K. R.). Potential conflicts of interest. All authors: No reported conflicts.
PY - 2013/5/1
Y1 - 2013/5/1
N2 - 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.
AB - 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.
KW - AIDS
KW - biomarkers
KW - hepatic flares
KW - hepatitis
UR - https://www.scopus.com/pages/publications/84875968965
U2 - 10.1093/infdis/jit033
DO - 10.1093/infdis/jit033
M3 - Article
C2 - 23335804
AN - SCOPUS:84875968965
SN - 0022-1899
VL - 207
SP - 1379
EP - 1388
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 9
ER -