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https://www.arca.fiocruz.br/handle/icict/24875
BIOMARKERS OF INFLAMMATION AND COAGULATION ARE ASSOCIATED WITH MORTALITY AND HEPATITIS FLARES IN PERSONS COINFECTED WITH HIV AND HEPATITIS VIRUSES
Author
Affilliation
National Institute of Allergy and Infectious Diseases. National Institutes of Health. Laboratory of Parasitic Diseases. Immunobiology Section. Bethesda, MD
University of Minnesota. Minneapolis, MN, EUA
University of Minnesota. Minneapolis, MN, EUA
National Cancer Institute. SAIC Frederick. Frederick, MD, EUA
University of Western Australia. Perth, Australia
Chulalongkorn University. Faculty of Medicine. Bangkok Thailand / Thai Red Cross AIDS Research Center. Bangkok Thailand
Hospital La Paz. Madrid, Spain
Clinical Trials Unit. London, United Kingdom
Hospital Carlos III. Madrid, Spain
The Alfred Hospital. Melbourne, Australia / Monash University. Melbourne, Australia
National Institute of Allergy and Infectious Diseases. National Institutes of Health. Laboratory of Parasitic Diseases. Immunobiology Section. Bethesda, MD, USA
The Alfred Hospital. Melbourne, Australia / Monash University. Melbourne, Australia / Burnet Institute. Melbourne, Australia
National Institute of Allergy Infectious Diseases. National Institutes of Health. Clinical and Molecular Retrovirology Section. Laboratory of Immunoregulation. Bethesda, MD
University of Minnesota. Minneapolis, MN, EUA
University of Minnesota. Minneapolis, MN, EUA
National Cancer Institute. SAIC Frederick. Frederick, MD, EUA
University of Western Australia. Perth, Australia
Chulalongkorn University. Faculty of Medicine. Bangkok Thailand / Thai Red Cross AIDS Research Center. Bangkok Thailand
Hospital La Paz. Madrid, Spain
Clinical Trials Unit. London, United Kingdom
Hospital Carlos III. Madrid, Spain
The Alfred Hospital. Melbourne, Australia / Monash University. Melbourne, Australia
National Institute of Allergy and Infectious Diseases. National Institutes of Health. Laboratory of Parasitic Diseases. Immunobiology Section. Bethesda, MD, USA
The Alfred Hospital. Melbourne, Australia / Monash University. Melbourne, Australia / Burnet Institute. Melbourne, Australia
National Institute of Allergy Infectious Diseases. National Institutes of Health. Clinical and Molecular Retrovirology Section. Laboratory of Immunoregulation. Bethesda, MD
Abstract
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 AIDSdefining
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.
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