Liver Stiffness Is Associated With Monocyte Activation in HIV-Infected Ugandans Without Viral Hepatitis
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Date
2013
Journal Title
Journal ISSN
Volume Title
Publisher
AIDS research and human retroviruses
Abstract
A high prevalence of liver stiffness, as determined by elevated transient elastography liver stiffness measurement,
was previously found in a cohort of HIV-infected Ugandans in the absence of chronic viral hepatitis. Given
the role of immune activation and microbial translocation in models of liver disease, a shared immune mechanism
was hypothesized in the same cohort without other overt causes of liver disease. This study examined
whether HIV-related liver stiffness was associated with markers of immune activation or microbial translocation
(MT). A retrospective case-control study of subjects with evidence of liver stiffness as defined by a transient
elastography stiffness measurement ‡ 9.3 kPa (cases = 133) and normal controls (n = 133) from Rakai, Uganda
was performed. Cases were matched to controls by age, gender, HIV, hepatitis B virus (HBV), and highly active
antiretroviral therapy (HAART) status. Lipopolysaccharide (LPS), endotoxin IgM antibody, soluble CD14
(sCD14), C-reactive protein (CRP), and D-dimer levels were measured. Conditional logistic regression was used
to estimate adjusted matched odds ratios (adjMOR) and 95% confidence intervals. Higher sCD14 levels were
associated with a 19% increased odds of liver stiffness (adjMOR = 1.19, p = 0.002). In HIV-infected individuals,
higher sCD14 levels were associated with a 54% increased odds of having liver stiffness (adjMOR = 1.54,
p < 0.001); however, the opposite was observed in HIV-negative individuals (adjMOR = 0.57, p = 0.001). No other
biomarker was significantly associated with liver stiffness, and only one subject was found to have detectable
LPS. Liver stiffness in HIV-infected Ugandans is associated with increased sCD14 indicative of monocyte activation
in the absence of viral hepatitis or microbial translocation, and suggests that HIV may be directly
involved in liver disease.
Description
Keywords
Liver Stiffness, Monocyte Activation, HIV-Infected Ugandans, Viral Hepatitis
Citation
Redd, A. D., Wendel, S. K., Grabowski, M. K., Ocama, P., Kiggundu, V., Bbosa, F., ... & Stabinski, L. (2013). Liver stiffness is associated with monocyte activation in HIV-infected Ugandans without viral hepatitis. AIDS research and human retroviruses, 29(7), 1026-1030. DOI: 10.1089/aid.2013.0004