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Systemic inflammation and liver damage in HIV/hepatitis C virus coinfection

Title: Systemic inflammation and liver damage in HIV/hepatitis C virus coinfection
Authors: Shmagel, KV; Saidakova, EV; Shmagel, NG; Korolevskaya, LB; Chereshnev, VA; Robinson, J; Grivel, J‐C; Douek, DC; Margolis, L; Anthony, DD; Lederman, MM
Contributors: National Institute of Allergy and Infectious Diseases
Source: HIV Medicine ; volume 17, issue 8, page 581-589 ; ISSN 1464-2662 1468-1293
Publisher Information: Wiley
Publication Year: 2016
Collection: Wiley Online Library (Open Access Articles via Crossref)
Description: Objectives Chronic hepatitis C virus ( HCV ) and HIV viral infections are characterized by systemic inflammation. Yet the relative levels, drivers and correlates of inflammation in these settings are not well defined. Methods Seventy‐nine HIV ‐infected patients who had been receiving antiretroviral therapy ( ART ) for more than 2 years and who had suppressed plasma HIV levels (< 50 HIV ‐1 RNA copies/mL) were included in the study. Two patient groups, HCV ‐positive/ HIV ‐positive and HCV ‐negative/ HIV ‐positive, and a control group comprised of healthy volunteers ( n = 20) were examined. Markers of systemic inflammation [interleukin ( IL )‐6, interferon gamma‐induced protein ( IP )‐10, soluble tumour necrosis factor receptor‐I ( sTNF ‐ RI ) and sTNF ‐ RII ], monocyte/macrophage activation [soluble CD 163 ( sCD 163), soluble CD14 and neopterin], intestinal epithelial barrier loss [intestinal fatty acid binding protein (I‐ FABP ) and lipopolysaccharide ( LPS )] and coagulation ( d ‐dimers) were analysed. CD 4 naïve T cells and CD 4 recent thymic emigrants ( RTE s) were enumerated. Results Plasma levels of IP ‐10, neopterin and sCD 163 were higher in HCV / HIV coinfection than in HIV monoinfection and were positively correlated with indices of hepatic damage [aspartate aminotransferase ( AST ), alanine aminotransferase ( ALT ) and the AST to platelet ratio index ( APRI )]. Levels of I‐ FABP were comparably increased in HIV monoinfection and HIV / HCV coinfection but LPS concentrations were highest in HCV / HIV coinfection, suggesting impaired hepatic clearance of LPS . Plasma HCV levels were not related to any inflammatory indices except sCD 163. In coinfected subjects, a previously recognized relationship of CD 4 naïve T‐cell and RTE counts to hepatocellular injury was defined more mechanistically by an inverse relationship to sCD 163. Conclusions Hepatocellular injury in HCV / HIV coinfection is linked to elevated levels of certain inflammatory cytokines and an apparent failure to clear systemically ...
Document Type: article in journal/newspaper
Language: English
DOI: 10.1111/hiv.12357
Availability: https://doi.org/10.1111/hiv.12357; https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fhiv.12357; https://onlinelibrary.wiley.com/doi/pdf/10.1111/hiv.12357
Rights: http://onlinelibrary.wiley.com/termsAndConditions#vor
Accession Number: edsbas.DC55DA79
Database: BASE