Changes in biomarkers of liver disease during successful combination antiretroviral therapy in HIV/HCV-coinfected individuals

Rohrbach, Janine; Stickel, Felix; Schmid, Patrick; Thormann, Wolfgang; Kovari, Helen; Scherrer, Alexandra; Günthard, Huldrych F.; Vuichard, Danielle; Cavassini, Matthias; Ambrosioni, Juan; Bernasconi, Enos; Furrer, Hansjakob; Rauch, Andri; Swiss HIV Cohort Study, The (2013). Changes in biomarkers of liver disease during successful combination antiretroviral therapy in HIV/HCV-coinfected individuals. Antiviral therapy, 19(2), pp. 149-159. International Medical Press 10.3851/IMP2686

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Background: We investigated changes in biomarkers of liver disease in HIV–HCV-coinfected individuals during successful combination antiretroviral therapy (cART) compared to changes in biomarker levels during untreated HIV infection and to HIV-monoinfected individuals.

Methods: Non-invasive biomarkers of liver disease (hyaluronic acid [HYA], aspartate aminotransferase-to-platelet ratio index [APRI], Fibrosis-4 [FIB-4] index and cytokeratin-18 [CK-18]) were correlated with liver histology in 49 HIV–HCV-coinfected patients. Changes in biomarkers over time were then assessed longitudinally in HIV–HCV-coinfected patients during successful cART (n=58), during untreated HIV-infection (n=59), and in HIV-monoinfected individuals (n=17). The median follow-up time was 3.4 years on cART. All analyses were conducted before starting HCV treatment.

Results: Non-invasive biomarkers of liver disease correlated significantly with the histological METAVIR stage (P<0.002 for all comparisons). The mean ±sd area under the receiver operating characteristic (AUROC) curve values for advanced fibrosis (≥F3 METAVIR) for HYA, APRI, FIB-4 and CK-18 were 0.86 ±0.05, 0.84 ±0.08, 0.80 ±0.09 and 0.81 ±0.07, respectively. HYA, APRI and CK-18 levels were higher in HIV–HCV-coinfected compared to HIV-monoinfected patients (P<0.01). In the first year on cART, APRI and FIB-4 scores decreased (-35% and -33%, respectively; P=0.1), mainly due to the reversion of HIV-induced thrombocytopaenia, whereas HYA and CK-18 levels remained unchanged. During long-term cART, there were only small changes (<5%) in median biomarker levels. Median biomarker levels changed <3% during untreated HIV-infection. Overall, 3 patients died from end-stage liver disease, and 10 from other causes.

Conclusions: Biomarkers of liver disease highly correlated with fibrosis in HIV–HCV-coinfected individuals and did not change significantly during successful cART. These findings suggest a slower than expected liver disease progression in many HIV–HCV-coinfected individuals, at least during successful cART.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology 04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases 04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases > Laboratory for Clinical Pharmacology
UniBE Contributor:	Rohrbach, Janine, Stickel, Felix, Thormann, Wolfgang, Furrer, Hansjakob, Rauch, Andri
Subjects:	600 Technology > 610 Medicine & health 500 Science > 570 Life sciences; biology
ISSN:	1359-6535
Publisher:	International Medical Press
Language:	English
Submitter:	Annelies Luginbühl
Date Deposited:	21 Mar 2014 09:31
Last Modified:	05 Dec 2022 14:29
Publisher DOI:	10.3851/IMP2686
PubMed ID:	24036684
URI:	https://boris.unibe.ch/id/eprint/44010