Liver fibrosis after antiretroviral therapy in a longitudinal cohort of sexually infected HIV patients in eastern China

Qian, Wei; Lin, Hung-Ching; Ding, Yingying; Liu, Xing; Qing, WU; Shen, Weiwei; Gao, Min; He, Na

doi:10.5582/bst.2017.01071

Cited by 11 publications

(13 citation statements)

References 46 publications

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“…In this study, we found that the positive rate of HBsAg for HIV-infected patients in Shaanxi Province was 11.7%, which was higher than the general population in either China or Shaanxi Province. A number of domestic studies have shown that the positive rate of HBsAg in the HIV-infected patients was higher than that of the general population, and it ranged from 13.1% to 19.4% [30][31][32][33]. However, on the contrary, some studies have reported that in HIV-infected patients, the HBsAg positive rate was slightly lower than that of the national general population.…”

Section: Discussionmentioning

confidence: 95%

Epidemiological Features and Risk Factors for Acquiring Hepatitis B, Hepatitis C, and Syphilis in HIV-Infected Patients in Shaanxi Province, Northwest China

Zhang¹,

Ren²,

Chang³

2020

IJERPH

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Human immunodeficiency virus (HIV)-infected patients are at a higher risk for co-infection with Hepatitis B virus (HBV), Hepatitis C virus (HCV), and Treponema pallidum (TP; the agent causing syphilis) than the general population. The prevalence of HBV, HCV, and syphilis has geographic differences and varies from region to region among HIV-positive individuals. A retrospective study was carried out on HIV-positive individuals between June 2011 and June 2016 in Shaanxi Province. Univariate and multivariate logistic regression analyses using stepwise regression analysis regarding risk factors for HIV-HBV, HIV-HCV, and HIV-syphilis co-infection. HBV-HCV, HCV-syphilis, HBV-syphilis, and HBV-HCV-syphilis co-infection rates were 1.7%, 2.2%, 2.6%, and 0.1%, respectively. The rate of ineffective hepatitis B vaccine immunization was as high as 30.2% among HIV-positive individuals. Ethnicity (OR = 31.030, 95% CI: 11.643-82.694) and HIV transmission routes (OR = 134.024, 95% CI: 14.328-1253.653) were the risk factors for HCV infection in HIV-positive individuals. Among the HIV-positive individuals with the antibodies of TP, the rate of homosexual transmission was also higher, but heterosexual transmission was lower (OR = 0.549 95% CI: 0.382-0.789) The HIV-infected patients in Shaanxi Province had the characteristics of low active detection rate and late diagnosis. The high rate of ineffective vaccination against HBV suggests a need for improved vaccination services.

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Section: Discussionmentioning

confidence: 95%

Epidemiological Features and Risk Factors for Acquiring Hepatitis B, Hepatitis C, and Syphilis in HIV-Infected Patients in Shaanxi Province, Northwest China

Zhang¹,

Ren²,

Chang³

2020

IJERPH

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“…Liver fibrosis can be induced by hepatitis B virus (HBV), hepatitis C virus (HCV), alcohol, long-term use of antiviral drugs, etc, and the process is accelerated by HIV infection (7,8). In China, especially in rural Yunnan, these risk factors are highly prevalent among HIV-infected patients (9,10). The prevalence was 77.7% for HCV infection and 15.5% for HIV/HCV coinfection among injecting drug users (IDU) in Yunnan province (11).…”

Section: Introductionmentioning

confidence: 99%

Fibrosis-4 index predicts mortality in HIV/HCV co-infected patients receiving combination antiretroviral therapy in rural China

Chen

Liu

Tang

et al. 2019

BST

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End-stage liver disease (ESLD) is among leading causes of death for people living with HIV and HCV. Little is known how liver fibrosis score predicts mortality in HIV/HCV co-infected population under combination antiretroviral therapy (cART). A retrospective cohort study of 691 HIV/HCV co-infected patients receiving cART in Yunnan, China from 2005 to 2016 was carried out to explore the association between Fibrosis-4 index (FIB-4) and all-cause mortality. Cox proportional hazard models were used to estimate the hazard ratios (HRs) for FIB-4 and covariates. After a median follow-up of 4.8 years with a total follow-up time of 3,696 person-years (PY), 131 deaths occurred and the all-cause mortality was 3.5 per 100 PY. The mortality was 2.9 (95% CI: 2.3-3.5)/100 PY for the FIB-4 ≤ 3.25 group and 5.8 (4.2-7.4)/100 PY for the FIB-4 > 3.25 group at baseline. People with FIB-4 changed from mild to advanced group showed HR of 1.81 (95% CI: 1.01-3.25) for death, and with FIB-4 sustaining advanced showed HR of 3.11 (1.75-5.54), both compared to those with FIB-4 remained mild, while lower risk of death was observed among married people (HR = 0.63, 95% CI: 0.41-0.99) compared to unmarried, among those with most recent CD4 + T cell counts between 200 and 350 cells/μL (0.50, 0.30-0.86) and > 350 cells/μL (0.25, 0.15-0.41) compared to CD4 under 200 cells/μL. Advanced and progressive liver fibrosis is a strong predictor of all-cause mortality in HIV/HCV co-infected patients under cART in China.

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“…Further, the liver plays a role in the metabolism of antiretroviral drugs, and in some studies NAFLD and fibrosis are exacerbated during combination antiretroviral treatment (cART), and is most often associated with low CD4 T cell counts, alcohol abuse, high immune activation, and exposure to certain ART drugs, such as didanosine [ 4 , 10 , 11 ]. Other studies have identified improvement of liver fibrosis during drug treatment, associated with better recovery of CD4 T cells during therapy and younger age [ 12 ]. Liver biopsies are currently considered to be the most precise method for diagnosing hepatic disease, however, this invasive procedure can have complications, such as pain, hemorrhage and sepsis, which make human studies difficult to conduct [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Liver macrophage-associated inflammation correlates with SIV burden and is substantially reduced following cART

et al. 2018

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Liver disease is a leading contributor to morbidity and mortality during HIV infection, despite the use of combination antiretroviral therapy (cART). The precise mechanisms of liver disease during HIV infection are poorly understood partially due to the difficulty in obtaining human liver samples as well as the presence of confounding factors (e.g. hepatitis co-infection, alcohol use). Utilizing the simian immunodeficiency virus (SIV) macaque model, a controlled study was conducted to evaluate the factors associated with liver inflammation and the impact of cART. We observed an increase in hepatic macrophages during untreated SIV infection that was associated with a number of inflammatory and fibrosis mediators (TNFα, CCL3, TGFβ). Moreover, an upregulation in the macrophage chemoattractant factor CCL2 was detected in the livers of SIV-infected macaques that coincided with an increase in the number of activated CD16+ monocyte/macrophages and T cells expressing the cognate receptor CCR2. Expression of Mac387 on monocyte/macrophages further indicated that these cells recently migrated to the liver. The hepatic macrophage and T cell levels strongly correlated with liver SIV DNA levels, and were not associated with the levels of 16S bacterial DNA. Utilizing in situ hybridization, SIV-infected cells were found primarily within portal triads, and were identified as T cells. Microarray analysis identified a strong antiviral transcriptomic signature in the liver during SIV infection. In contrast, macaques treated with cART exhibited lower levels of liver macrophages and had a substantial, but not complete, reduction in their inflammatory profile. In addition, residual SIV DNA and bacteria 16S DNA were detected in the livers during cART, implicating the liver as a site on-going immune activation during antiretroviral therapy. These findings provide mechanistic insights regarding how SIV infection promotes liver inflammation through macrophage recruitment, with implications for in HIV-infected individuals.

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Liver fibrosis after antiretroviral therapy in a longitudinal cohort of sexually infected HIV patients in eastern China

Cited by 11 publications

References 46 publications

Epidemiological Features and Risk Factors for Acquiring Hepatitis B, Hepatitis C, and Syphilis in HIV-Infected Patients in Shaanxi Province, Northwest China

Epidemiological Features and Risk Factors for Acquiring Hepatitis B, Hepatitis C, and Syphilis in HIV-Infected Patients in Shaanxi Province, Northwest China

Fibrosis-4 index predicts mortality in HIV/HCV co-infected patients receiving combination antiretroviral therapy in rural China

Liver macrophage-associated inflammation correlates with SIV burden and is substantially reduced following cART

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