Predictive value of liver enzymes and inflammatory biomarkers for the severity of liver fibrosis stage in HIV/HCV co-infected patients

PLoS One. 2013;8(3):e59205. doi: 10.1371/journal.pone.0059205. Epub 2013 Mar 19.

Abstract

Objective: The aim of our study was to assess a possible association between plasma inflammatory biomarkers (CRP, IL-6, soluble CD14) and the extent of fibrosis or cirrhosis using a FibroScan® in HIV/HCV co-infected patients.

Methods: This cross-sectional study assessed 60 HIV/HCV co-infected patients who had paired plasma samples and FibroScan® values available. All included patients were controlled for HIV infection (HIV-1 RNA <50 copies/mL) and had detectable HCV RNA levels. Levels of three biomarkers were measured in all samples using commercial ELISA kits. Multivariate logistic regression models identified factors associated with the METAVIR stages of fibrosis (F0-F2 vs. F3-F4).

Results: In univariate logistic regression analyses, in addition to sCD14 (odds ratio [OR] = 3.23, 95% confidence interval [95%CI] = 1.30-7.97, P = 0.01), aspartate aminotransferase (AST), alanine aminotransferase, platelet counts, and CD4 cell counts were associated with the stage of liver fibrosis and, thus, were introduced into the model. However, only AST (OR = 1.06, 95%CI = 1.02-1.10, P = 0.0009) was independently associated with F3-F4 stage liver fibrosis.

Conclusions: In our study of HIV/HCV co-infected patients, sCD14 plasma level, a biomarker of monocyte activation, was not independently associated with the F3-F4 stage of liver fibrosis. We hypothesize that the higher levels of inflammation markers observed in HIV/HCV co-infected patients, compared to HCV mono-infected patients, prevent this association being observed within this population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alanine Transaminase / blood
  • Aspartate Aminotransferases / blood
  • Biomarkers / blood*
  • C-Reactive Protein
  • CD4-Positive T-Lymphocytes / immunology
  • Coinfection / complications*
  • Cross-Sectional Studies
  • Enzyme-Linked Immunosorbent Assay
  • HIV Infections / complications*
  • Hepatitis C / complications*
  • Humans
  • Interleukin-6
  • Lipopolysaccharide Receptors
  • Liver Cirrhosis / blood
  • Liver Cirrhosis / diagnosis*
  • Liver Cirrhosis / enzymology
  • Liver Cirrhosis / etiology*
  • Logistic Models

Substances

  • Biomarkers
  • Interleukin-6
  • Lipopolysaccharide Receptors
  • C-Reactive Protein
  • Aspartate Aminotransferases
  • Alanine Transaminase

Grants and funding

This study was supported by French National Agency for Research on AIDS and viral hepatitis (Agence Nationale de Recherches sur le SIDA et les hépatites virales [ANRS]) and from the European Community’s Seventh Framework Programme (FP7/2007–2013) under the project “Collaborative HIV and Anti-HIV Drug Resistance Network (CHAIN)” (grant no. 223131). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.