Human immunodeficiency virus, hepatitis C, and inflammatory biomarkers in individuals with alcohol problems: a cross-sectional study

BMC Infectious Diseases

Matthew S Freiberg⁶  Jeffrey H Samet³  Jason V Baker⁴  Russell P Tracy²  Debbie M Cheng¹  Emily K Quinn⁷  Kaku A Armah⁵ 

[1] Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA;Departments of Pathology and Biochemistry, College of Medicine, University of Vermont, Burlington, VT, USA;Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA;Department of Medicine, University of Minnesota, Hennepin County Medical Center, Minnesota, MN, USA;Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA;Division of General Internal Medicine, Center for Research on Health Care, University of Pittsburgh Medical Center, 230 McKee Pl, Suite 600, Pittsburgh, PA 15213, USA;Data Coordinating Center, Boston University School of Public Health, Boston, MA, USA

关键词: Comorbidity;    Liver;    Alcohol;    Inflammation;    HCV;    HIV;   

Others  :  1145918
DOI  :  10.1186/1471-2334-13-399

 received in 2013-04-21, accepted in 2013-08-20,  发布年份 2013

【 摘 要 】

Background

Assessing whether hepatitis C (HCV) co-infection with human immunodeficiency virus (HIV) is associated with increased inflammation is complex. The liver, integral to inflammatory biomarker synthesis, is compromised by HCV and alcohol abuse. Using single liver-synthesized biomarkers (e.g. C-reactive protein) to represent inflammation may not be appropriate in HIV/HCV co-infection. We hypothesized that 1) detectable HIV/HCV RNA was independently associated with increased inflammation; 2) a composite inflammation measure describes inflammation differently from single inflammatory biomarkers.

Methods

We compared inflammation by HIV/HCV group in a cohort of 361 HIV infected participants from the HIV-Longitudinal Interrelationships of Viruses and Ethanol study. Inflammatory biomarkers >75th percentile were considered elevated. Associations between HIV/HCV group and elevated biomarkers were analyzed as a composite measure (inflammatory burden) or individually. We defined inflammatory burden as number of concurrently elevated biomarkers. Biomarkers included interleukin-6 (IL-6), C-reactive protein (CRP), cystatin C, serum amyloid-A (SAA), tumor necrosis factor-alpha (TNF-α), interleukin-10 (IL-10). Covariates: alcohol, liver fibrosis, comorbidities, CD4 count, antiretroviral therapy, substance use.

Results

Detectable HIV and HCV RNA (OR = 2.49; 95% CI = 1.05–5.89) and detectable HCV RNA alone (2.95; 1.08–8.01) were independently associated with increased odds of having a greater inflammatory burden compared to undetectable viremia. Elevated IL-10 (7.79; 1.90–31.97) and TNF-α (7.70; 1.42–41.83) were independently associated with detectable HIV and HCV RNA. Elevated IL-10 was also associated with detectable HCV RNA alone (5.51; 1.17, 25.84).

Conclusions

Detectable HIV and HCV replication versus undetectable replication was associated with inflammatory burden and certain inflammatory biomarkers independently of alcohol consumption, liver fibrosis and other comorbidities.

【 授权许可】

   
2013 Armah et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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