Liver fibrosis, microbial translocation and immune activation markers in HIV and HCV infections and in HIV/HCV co-infection

Dig Liver Dis. 2015 Mar;47(3):218-25. doi: 10.1016/j.dld.2014.11.012. Epub 2014 Nov 29.

Abstract

Background: Liver fibrosis is accelerated in patients co-infected with human immunodeficiency virus and hepatitis C viruses.

Aims: We investigated the correlation between liver fibrosis, immune activation and microbial translocation.

Methods: This cross-sectional study included patients with hepatitis C virus (HCV) and human immunodeficiency virus (HIV) mono-infections, HIV/HCV co-infection, and healthy controls (20 subjects/group). Peripheral blood was analysed to determine the levels of Forkhead box 3 (Foxp3) T cells, TGF-β1, CD14 (soluble and surface isoforms), IL-17 and bacterial translocation products. These measurements were correlated to the severity of liver fibrosis, measured with the FIB-4 score and transient elastography.

Results: Foxp3T cell levels were significantly elevated in HIV mono-infected and co-infected groups (p<0.0005). FIB-4 and liver stiffness values inversely correlated with TGF-β1 (p=0.0155 and p=0.0498). Bacterial DNA differed significantly in the HIV-positive compared to the other groups: HIV/HCV co-infected subjects had significantly higher serum levels of bacterial translocation products, CD14, and IL-17 levels (p<0.001).

Conclusions: Fibrosis stage in HIV/HCV co-infection may be influenced by immune activation due either by viral infections or to bacterial translocation.

Keywords: Bacterial translocation; HIV immunity; HIV/HCV co-infection; Liver fibrosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bacterial Translocation*
  • Biomarkers / blood
  • CD4-Positive T-Lymphocytes / cytology
  • Case-Control Studies
  • Coinfection
  • Cross-Sectional Studies
  • DNA, Bacterial / genetics
  • Elasticity Imaging Techniques
  • Female
  • HIV Infections / immunology*
  • Hepacivirus
  • Hepatitis C / immunology*
  • Humans
  • Interleukin-17 / blood
  • Linear Models
  • Lipopolysaccharide Receptors / blood
  • Liver Cirrhosis / diagnosis*
  • Liver Cirrhosis / virology*
  • Male
  • Middle Aged
  • RNA, Viral / genetics
  • Transforming Growth Factor beta1 / blood

Substances

  • Biomarkers
  • DNA, Bacterial
  • Interleukin-17
  • Lipopolysaccharide Receptors
  • RNA, Viral
  • Transforming Growth Factor beta1