Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Mandorfer, M; Payer, BA; Schwabl, P; Steiner, S; Ferlitsch, A; Aichelburg, MC; Stättermayer, AF; Ferenci, P; Obermayer-Pietsch, B; Grabmeier-Pfistershammer, K; Trauner, M; Peck-Radosavljevic, M; Reiberger, T.
Revisiting liver disease progression in HIV/HCV-coinfected patients: the influence of vitamin D, insulin resistance, immune status, IL28B and PNPLA3.
Liver Int. 2015; 35(3):876-885
Doi: 10.1111/liv.12615
Web of Science
PubMed
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- Co-Autor*innen der Med Uni Graz
- Obermayer-Pietsch Barbara
- Trauner Michael
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- Abstract:
- To perform a comprehensive study on independent modulators of liver fibrosis progression and determinants of portal pressure considering immune status, insulin resistance (IR), serum 25-hydroxyvitamin D (25(OH)D) levels, genetic variants of patatin-like phospholipase domain-containing protein 3 (PNPLA3) and interleukin 28B (IL28B) in a thoroughly documented cohort of HIV/hepatitis C-coinfected (HIV/HCV) patients. 25(OH)D deficiency (25(OH)DDEF), IR and low CD4(+) T-lymphocyte nadir (lowCD4NAD) were defined as 25(OH)D <20 ng × ml(-1) , HOMA-IR >2 and CD4nadir <200 cells × μl(-1) respectively. Liver fibrosis progression rate (FPR) was calculated as METAVIR F units divided by the number of years since HCV infection. Patients with a FPR > median FPR were assigned to the highFPR group. Among 86 HIV/HCV, the median FPR was 0.167 units × years(-1) . While the prevalence of prior alcohol abuse, lowCD4NAD and 25(OH)DDEF was higher among highFPR patients, the prevalence of IR was comparable. The association between 25(OH)DDEF and FPR was confirmed in a subgroup of patients with METAVIR stage F0/F1/F2 in which 25(OH)D levels are not affected by the severity of liver disease. The distribution of IL28B C/C and PNPLA3 non-C/C was similar, while PNPLA3 G/G was exclusively observed in highFPR patients. LowCD4NAD (OR: 2.95; 95% CI: 1.05-8.24; P = 0.039) and 25(OH)DDEF (OR: 5.62; 95% CI: 2.05-15.38; P = 0.001) were independently associated with highFPR and showed an additive effect. Portal pressure correlated with prior alcohol abuse, HCV-genotype 3, CD4(+) nadir and 25(OH)D levels. Two potentially modifiable factors, CD4(+) nadir and 25(OH)D levels, were both independent modulators of liver fibrosis progression and determinants of portal pressure. Further studies are warranted to assess the relevance of PNPLA3 for FPR in HIV/HCV. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Coinfection - immunology
- Coinfection - virology
- Disease Progression -
- Female -
- Genotype -
- HIV -
- HIV Infections - complications
- HIV Infections - immunology
- Hepatitis C -
- Hepatitis C, Chronic - complications
- Hepatitis C, Chronic - immunology
- Humans -
- Insulin Resistance -
- Interleukins - genetics
- Lipase - genetics
- Liver - physiopathology
- Liver Cirrhosis - complications
- Liver Cirrhosis - pathology
- Male -
- Membrane Proteins - genetics
- Middle Aged -
- Multivariate Analysis -
- Portal Pressure -
- Retrospective Studies -
- Vitamin D - analogs & derivatives
- Vitamin D - blood
- Find related publications in this database (Keywords)
- chronic hepatitis C
- cirrhosis
- human immunodeficiency virus
- liver fibrosis
- portal hypertension