Plasma IP-10 and IL-6 are linked to Child-Pugh B cirrhosis in patients with advanced HCV-related cirrhosis: a cross-sectional study

Abstract

We aimed to evaluate the association of plasma biomarkers linked to inflammation (bacterial translocation, inflammatory response, and endothelial dysfunction), coagulopathy, and angiogenesis with the severity of liver cirrhosis (assessed by the Child-Pugh-Turcotte score, CTP) and Child-Pugh B cirrhosis (CTP 7-9) in patients with advanced hepatitis C virus (HCV)-related cirrhosis. We carried out a cross-sectional study in 97 patients with advanced HCV-related cirrhosis (32 HCV-monoinfected and 65 HIV/HCV-coinfected). Plasma biomarkers were measured by ProcartaPlex multiplex immunoassays. The outcome variable was the CTP score and the Child-Pugh B cirrhosis (CTP 7-9). HIV/HCV-coinfected patients and HCV-monoinfected patients with advanced HCV-related cirrhosis had near-equivalent values of plasma biomarkers. Higher values of plasma biomarkers linked to an inflammatory response (IP-10, IL-8, IL-6, and OPG), endothelial dysfunction (sVCAM-1 and sICAM-1), and coagulopathy (D-dimer) were related to higher CTP values. The most significant biomarkers to detect the presence of Child-Pugh B cirrhosis (CTP 7-9) were IP-10 (p-value= 0.008) and IL-6 (p-value=0.002). The AUC-ROC values of IP-10, IL-6, and both biomarkers combined (IP-10+IL-6) were 0.78, 0.88, and 0.96, respectively. In conclusion, HIV infection does not appear to have a significant impact on the analyzed plasma biomarkers in patients with advanced HCV-related cirrhosis. However, plasma biomarkers linked to inflammation (inflammatory response and endothelial dysfunction) were related to the severity of liver cirrhosis (CTP score), mainly IP-10 and IL-6, which discriminated patients with Child-Pugh B concerning Child-Pugh A. The hepatitis C virus (HCV) has a prevalence of active infection of around 1% worldwide (71 million people) 1. HCV-infected patients progress slowly during decades (10 to 20 years), developing liver fibrosis and cirrhosis, which can evolve into decompensated cirrhosis and hepatocellular carcinoma 2. Chronic hepatitis C causes chronic liver inflammation that accelerates the development of cirrhosis and other comorbidities 3,4. The cirrhosis-associated immune dysfunction (CAID) is a pathophysiological process that appears in cirrhosis and is enhanced in advanced cirrhosis. The CAID is characterized by higher levels of inflammation, immune activation, and deregulation of the immune system, which are related to the progression to hepatic decompensation 5,6. Patients with hepatic decompensation (Child-Turcotte-Pugh, CTP class B or C) could develop complications

Successful HCV Therapy Reduces Liver Disease Severity and Inflammation Biomarkers in HIV/HCV-Coinfected Patients With Advanced Cirrhosis: A Cohort Study

“…A recent article on HIV/HCV-coinfected patients showed that plasma biomarkers of bacterial translocation, inflammation, endothelial dysfunction, and coagulopathy increased with increased liver fibrosis severity, particularly in patients with LSM ≥ 40 KPa ( 35 ). Besides, plasma IP-10 and IL-6 have also been correlated to advanced liver disease (CTP 7-9) ( 42 ). However, the eradication of HCV with antiviral therapy can stop this pathological process of the liver, at least almost entirely ( 34 ).…”

Association Between Serum IL-6, IL-10, IL-12, and IL-23 Levels and Severity of Liver Cirrhosis

“…Overt hepatic encephalopathy was diagnosed clinically based on impairment mental status as defined by the West Haven Criteria (WHC) and impairment neuromotor function. It was assessed using psychometric hepatic encephalopathy score (PHES) ( 15 ). Ascites was assessed by physical examination and abdominal ultrasound.…”

Alteraciones de coagulación en los pacientes con cirrosis hepática atendidos en un hospital Universitario de Colombia

“…El uso de escalas es importante para determinar el pronóstico de los pacientes que presentan esta entidad pa- tológica puesto que permiten predecir el riesgo de mortalidad según el curso natural de la enfermedad, una de las escalas de mayor aplicación a nivel mundial es el Child Pugh que evalúa el pronóstico de mortalidad, donde a mayor puntaje se incrementa este riesgo 26,27 . Adicionalmente, se ha encontrado que el uso de la escala de Child Pugh continúa siendo relevante para predecir la aparición de coagulopatías puesto que, al clasificar el grado de disfunción hepática, permite identificar la gravedad de la enfermedad y asociarse con un mayor riesgo de sangrados o hemorragias debido a los trastornos de la coagulación [28][29][30] . Teniendo presente lo anterior es importante recalcar que los índices de coagulación (PT, PTT), los factores de coagulación, los parámetros plaquetarios y la función hepática reflejan eficazmente el nivel de lesión hepática, lo cual se relaciona con la gravedad de la lesión hepática, y pueden proporcionar evidencia para el diagnóstico precoz de pacientes con cirrosis con importancia clínica 30 .…”