Journal
JOURNAL OF INFECTIOUS DISEASES
Volume 207, Issue 9, Pages 1379-1388Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jit033
Keywords
hepatic flares; biomarkers; AIDS; hepatitis
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Funding
- National Institute of Allergy and Infectious Diseases (NIAID) [3 U01 AI068641-05S1, U01AI042170, U01AI046362]
- NIAID Intramural Research Program
- National Institutes of Health
- National Research University Project of CHE
- Ratchadaphiseksomphot Endowment Fund, Thailand [HR1161A]
- National Science and Technology Development Agency, BIOTEC
- Thai Research Fund, Thailand
- MRC [MC_UU_12023/16, MC_U122886352] Funding Source: UKRI
- Medical Research Council [MC_UU_12023/16, MC_U122886352] Funding Source: researchfish
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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.
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