Biomarkers of inflammation and coagulation are associated with mortality and hepatitis flares in persons coinfected with HIV and hepatitis viruses

Bruno B Andrade, Katherine H Hullsiek, David R Boulware, Adam Rupert, Martyn A French, Kiat Ruxrungtham, Marisa L Montes, Huw Price, Pablo Barreiro, Jennifer M Audsley, Alan Sher, Sharon Ruth Lewin, Irini Sereti

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Abstract

Background. Hepatitis C virus (HCV) and/or hepatitis B virus (HBV) coinfection with human immunodeficiency virus (HIV) has a greater risk of mortality than either HCV or HBV infection alone and is frequently associated with hepatitis flares after antiretroviral therapy (ART) initiation. Methods. We performed a retrospective cohort study of 287 HIV-positive persons coinfected with HBV and/or HCV (70 had HBV coinfection only, 207 had HCV coninfection only, and 10 had HBV and HCV coinfections) who had pre-ART plasma samples evaluated for biomarkers associated with death (within 4 years) and/or hepatitis flare (within 4 months) after ART initiation. A predictive biomarker risk score was calculated. Results. Forty-eight deaths and 50 hepatitis flares occurred. Nonsurvivors were older, had more prior AIDS-defining events, and had higher pre-ART triglycerides and aspartate transaminase levels. Detectable hyaluronic acid and higher d-dimer, interleukin 6, interleukin 8, and soluble CD14 levels were associated with death in univariate models and with a composite biomarker risk score. The risk of hepatitis flares was higher with HBV coinfection only (24.3 ) and with HBV and HCV coinfection (50 ) than with HCV coinfection only (13.5 ). Higher levels of alanine transaminase and interleukin 10 were also associated with hepatitis flares. Conclusions. Among HIV-positive patients coinfected with HBV and/or HCV who are initiating ART, biomarkers of inflammation and coagulation are associated with an increased risk of death, whereas HBV coinfection and higher pre-ART interleukin 10 levels are associated with hepatitis flares.
Original languageEnglish
Pages (from-to)1379 - 1388
Number of pages10
JournalJournal of Infectious Diseases
Volume207
Issue number9
DOIs
Publication statusPublished - 2013

Cite this

Andrade, B. B., Hullsiek, K. H., Boulware, D. R., Rupert, A., French, M. A., Ruxrungtham, K., ... Sereti, I. (2013). Biomarkers of inflammation and coagulation are associated with mortality and hepatitis flares in persons coinfected with HIV and hepatitis viruses. Journal of Infectious Diseases, 207(9), 1379 - 1388. https://doi.org/10.1093/infdis/jit033
Andrade, Bruno B ; Hullsiek, Katherine H ; Boulware, David R ; Rupert, Adam ; French, Martyn A ; Ruxrungtham, Kiat ; Montes, Marisa L ; Price, Huw ; Barreiro, Pablo ; Audsley, Jennifer M ; Sher, Alan ; Lewin, Sharon Ruth ; Sereti, Irini. / Biomarkers of inflammation and coagulation are associated with mortality and hepatitis flares in persons coinfected with HIV and hepatitis viruses. In: Journal of Infectious Diseases. 2013 ; Vol. 207, No. 9. pp. 1379 - 1388.
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title = "Biomarkers of inflammation and coagulation are associated with mortality and hepatitis flares in persons coinfected with HIV and hepatitis viruses",
abstract = "Background. Hepatitis C virus (HCV) and/or hepatitis B virus (HBV) coinfection with human immunodeficiency virus (HIV) has a greater risk of mortality than either HCV or HBV infection alone and is frequently associated with hepatitis flares after antiretroviral therapy (ART) initiation. Methods. We performed a retrospective cohort study of 287 HIV-positive persons coinfected with HBV and/or HCV (70 had HBV coinfection only, 207 had HCV coninfection only, and 10 had HBV and HCV coinfections) who had pre-ART plasma samples evaluated for biomarkers associated with death (within 4 years) and/or hepatitis flare (within 4 months) after ART initiation. A predictive biomarker risk score was calculated. Results. Forty-eight deaths and 50 hepatitis flares occurred. Nonsurvivors were older, had more prior AIDS-defining events, and had higher pre-ART triglycerides and aspartate transaminase levels. Detectable hyaluronic acid and higher d-dimer, interleukin 6, interleukin 8, and soluble CD14 levels were associated with death in univariate models and with a composite biomarker risk score. The risk of hepatitis flares was higher with HBV coinfection only (24.3 ) and with HBV and HCV coinfection (50 ) than with HCV coinfection only (13.5 ). Higher levels of alanine transaminase and interleukin 10 were also associated with hepatitis flares. Conclusions. Among HIV-positive patients coinfected with HBV and/or HCV who are initiating ART, biomarkers of inflammation and coagulation are associated with an increased risk of death, whereas HBV coinfection and higher pre-ART interleukin 10 levels are associated with hepatitis flares.",
author = "Andrade, {Bruno B} and Hullsiek, {Katherine H} and Boulware, {David R} and Adam Rupert and French, {Martyn A} and Kiat Ruxrungtham and Montes, {Marisa L} and Huw Price and Pablo Barreiro and Audsley, {Jennifer M} and Alan Sher and Lewin, {Sharon Ruth} and Irini Sereti",
year = "2013",
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language = "English",
volume = "207",
pages = "1379 -- 1388",
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Andrade, BB, Hullsiek, KH, Boulware, DR, Rupert, A, French, MA, Ruxrungtham, K, Montes, ML, Price, H, Barreiro, P, Audsley, JM, Sher, A, Lewin, SR & Sereti, I 2013, 'Biomarkers of inflammation and coagulation are associated with mortality and hepatitis flares in persons coinfected with HIV and hepatitis viruses', Journal of Infectious Diseases, vol. 207, no. 9, pp. 1379 - 1388. https://doi.org/10.1093/infdis/jit033

Biomarkers of inflammation and coagulation are associated with mortality and hepatitis flares in persons coinfected with HIV and hepatitis viruses. / Andrade, Bruno B; Hullsiek, Katherine H; Boulware, David R; Rupert, Adam; French, Martyn A; Ruxrungtham, Kiat; Montes, Marisa L; Price, Huw; Barreiro, Pablo; Audsley, Jennifer M; Sher, Alan; Lewin, Sharon Ruth; Sereti, Irini.

In: Journal of Infectious Diseases, Vol. 207, No. 9, 2013, p. 1379 - 1388.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Biomarkers of inflammation and coagulation are associated with mortality and hepatitis flares in persons coinfected with HIV and hepatitis viruses

AU - Andrade, Bruno B

AU - Hullsiek, Katherine H

AU - Boulware, David R

AU - Rupert, Adam

AU - French, Martyn A

AU - Ruxrungtham, Kiat

AU - Montes, Marisa L

AU - Price, Huw

AU - Barreiro, Pablo

AU - Audsley, Jennifer M

AU - Sher, Alan

AU - Lewin, Sharon Ruth

AU - Sereti, Irini

PY - 2013

Y1 - 2013

N2 - Background. Hepatitis C virus (HCV) and/or hepatitis B virus (HBV) coinfection with human immunodeficiency virus (HIV) has a greater risk of mortality than either HCV or HBV infection alone and is frequently associated with hepatitis flares after antiretroviral therapy (ART) initiation. Methods. We performed a retrospective cohort study of 287 HIV-positive persons coinfected with HBV and/or HCV (70 had HBV coinfection only, 207 had HCV coninfection only, and 10 had HBV and HCV coinfections) who had pre-ART plasma samples evaluated for biomarkers associated with death (within 4 years) and/or hepatitis flare (within 4 months) after ART initiation. A predictive biomarker risk score was calculated. Results. Forty-eight deaths and 50 hepatitis flares occurred. Nonsurvivors were older, had more prior AIDS-defining events, and had higher pre-ART triglycerides and aspartate transaminase levels. Detectable hyaluronic acid and higher d-dimer, interleukin 6, interleukin 8, and soluble CD14 levels were associated with death in univariate models and with a composite biomarker risk score. The risk of hepatitis flares was higher with HBV coinfection only (24.3 ) and with HBV and HCV coinfection (50 ) than with HCV coinfection only (13.5 ). Higher levels of alanine transaminase and interleukin 10 were also associated with hepatitis flares. Conclusions. Among HIV-positive patients coinfected with HBV and/or HCV who are initiating ART, biomarkers of inflammation and coagulation are associated with an increased risk of death, whereas HBV coinfection and higher pre-ART interleukin 10 levels are associated with hepatitis flares.

AB - Background. Hepatitis C virus (HCV) and/or hepatitis B virus (HBV) coinfection with human immunodeficiency virus (HIV) has a greater risk of mortality than either HCV or HBV infection alone and is frequently associated with hepatitis flares after antiretroviral therapy (ART) initiation. Methods. We performed a retrospective cohort study of 287 HIV-positive persons coinfected with HBV and/or HCV (70 had HBV coinfection only, 207 had HCV coninfection only, and 10 had HBV and HCV coinfections) who had pre-ART plasma samples evaluated for biomarkers associated with death (within 4 years) and/or hepatitis flare (within 4 months) after ART initiation. A predictive biomarker risk score was calculated. Results. Forty-eight deaths and 50 hepatitis flares occurred. Nonsurvivors were older, had more prior AIDS-defining events, and had higher pre-ART triglycerides and aspartate transaminase levels. Detectable hyaluronic acid and higher d-dimer, interleukin 6, interleukin 8, and soluble CD14 levels were associated with death in univariate models and with a composite biomarker risk score. The risk of hepatitis flares was higher with HBV coinfection only (24.3 ) and with HBV and HCV coinfection (50 ) than with HCV coinfection only (13.5 ). Higher levels of alanine transaminase and interleukin 10 were also associated with hepatitis flares. Conclusions. Among HIV-positive patients coinfected with HBV and/or HCV who are initiating ART, biomarkers of inflammation and coagulation are associated with an increased risk of death, whereas HBV coinfection and higher pre-ART interleukin 10 levels are associated with hepatitis flares.

UR - http://jid.oxfordjournals.org/content/207/9/1379.full.pdf

U2 - 10.1093/infdis/jit033

DO - 10.1093/infdis/jit033

M3 - Article

VL - 207

SP - 1379

EP - 1388

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

SN - 0022-1899

IS - 9

ER -