Liver fibrosis, microbial translocation and immune activation markers in HIV and HCV infections and in HIV/HCV co-infection

Abstract Background Liver fibrosis is accelerated in patients co-infected with human immunodeficiency virus and hepatitis C viruses. Aims We investigated the correlation between liver fibrosis, immune activation and microbial translocation. Methods This cross-sectional study included patients with h...

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Bibliographic Details
Published in:Digestive and liver disease 2015-03, Vol.47 (3), p.218-225
Main Authors: Sacchi, Paolo, Cima, Serena, Corbella, Marta, Comolli, Giuditta, Chiesa, Antonella, Baldanti, Fausto, Klersy, Catherine, Novati, Stefano, Mulatto, Patrizia, Mariconti, Mara, Bazzocchi, Chiara, Puoti, Massimo, Pagani, Laura, Filice, Gaetano, Bruno, Raffaele
Format: Article
Language:English
Subjects:
Adult
Bacterial Translocation
Biomarkers - blood
Case-Control Studies
CD4-Positive T-Lymphocytes - cytology
Coinfection
Cross-Sectional Studies
DNA, Bacterial - genetics
Elasticity Imaging Techniques
Female
Gastroenterology and Hepatology
Hepacivirus
Hepatitis C - immunology
HIV immunity
HIV Infections - immunology
HIV/HCV co-infection
Humans
Interleukin-17 - blood
Linear Models
Lipopolysaccharide Receptors - blood
Liver Cirrhosis - diagnosis
Liver Cirrhosis - virology
Liver fibrosis
Male
Middle Aged
RNA, Viral - genetics
Transforming Growth Factor beta1 - blood
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Summary:Abstract Background Liver fibrosis is accelerated in patients co-infected with human immunodeficiency virus and hepatitis C viruses. Aims We investigated the correlation between liver fibrosis, immune activation and microbial translocation. Methods This cross-sectional study included patients with hepatitis C virus (HCV) and human immunodeficiency virus (HIV) mono-infections, HIV/HCV co-infection, and healthy controls (20 subjects/group). Peripheral blood was analysed to determine the levels of Forkhead box 3 (Foxp3) T cells, TGF-β1, CD14 (soluble and surface isoforms), IL-17 and bacterial translocation products. These measurements were correlated to the severity of liver fibrosis, measured with the FIB-4 score and transient elastography. Results Foxp3T cell levels were significantly elevated in HIV mono-infected and co-infected groups ( p < 0.0005). FIB-4 and liver stiffness values inversely correlated with TGF-β1 ( p = 0.0155 and p = 0.0498). Bacterial DNA differed significantly in the HIV-positive compared to the other groups: HIV/HCV co-infected subjects had significantly higher serum levels of bacterial translocation products, CD14, and IL-17 levels ( p < 0.001). Conclusions Fibrosis stage in HIV/HCV co-infection may be influenced by immune activation due either by viral infections or to bacterial translocation.
ISSN:1590-8658
1878-3562
DOI:10.1016/j.dld.2014.11.012