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HIV Med. 2016 Sep;17(8):581-9. doi: 10.1111/hiv.12357. Epub 2016 May 17.

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

Author information

1
Institute of Ecology and Genetics of Microorganisms UB RAS, Perm, Russia.
2
Perm State University, Perm, Russia.
3
Perm Regional Center for Protection against AIDS and Infectious Diseases, Perm, Russia.
4
Institute of Immunology and Physiology UB RAS, Yekaterinburg, Russia.
5
Case Western Reserve University, Cleveland, OH, USA.
6
National Institute of Child Health and Development, Bethesda, MD, USA.
7
Vaccine Research Center, National Institutes of Health, Bethesda, MD, USA.

Abstract

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 CD163 (sCD163), soluble CD14 and neopterin], intestinal epithelial barrier loss [intestinal fatty acid binding protein (I-FABP) and lipopolysaccharide (LPS)] and coagulation (d-dimers) were analysed. CD4 naïve T cells and CD4 recent thymic emigrants (RTEs) were enumerated.

RESULTS:

Plasma levels of IP-10, neopterin and sCD163 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 sCD163. In coinfected subjects, a previously recognized relationship of CD4 naïve T-cell and RTE counts to hepatocellular injury was defined more mechanistically by an inverse relationship to sCD163.

CONCLUSIONS:

Hepatocellular injury in HCV/HIV coinfection is linked to elevated levels of certain inflammatory cytokines and an apparent failure to clear systemically translocated microbial products. A related decrease in CD4 naïve T cells and RTEs also merits further exploration.

KEYWORDS:

CD31; HIV infections; antigens; hepatitis C; highly active antiretroviral therapy; inflammation mediators

PMID:
27187749
PMCID:
PMC4987156
DOI:
10.1111/hiv.12357
[Indexed for MEDLINE]
Free PMC Article

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