Mechanisms of Accelerated Liver Fibrosis Progression during HIV Infection

Debes, José D.; Bohjanen, Paul R.; Boonstra, André

doi:10.14218/jcth.2016.00034

Cited by 29 publications

(21 citation statements)

References 95 publications

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“…Similar findings have been observed in the US [11]. Several mechanisms underlying the association between HIV and liver fibrosis have been proposed [12]. The strong association between HIV VL and APRI > 0.5 in both HIV and HIV/HBV infected patients that was seen in this study suggests an effect of HIV itself on the liver.…”

Section: Discussionsupporting

confidence: 90%

Brief Report: HIV/HBV Coinfection is a Significant Risk Factor for Liver Fibrosis in Tanzanian HIV-Infected Adults

Hawkins

Christian

Fabian

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background In sub-Saharan Africa, the burden of liver disease associated with chronic hepatitis B (HBV) and HIV is unknown. We characterized liver disease using aspartate aminotransferase-to-platelet ratio index (APRI) and FIB-4 in patients with HIV, HBV, and HIV/HBV co-infection in Tanzania. Methods Using a cross sectional design, we compared the prevalence of liver fibrosis in treatment-naive HIV mono-infected, HBV mono-infected, and HIV/HBV co-infected adults enrolled at Management and Development for Health (MDH)-supported HIV treatment clinics in Dar es Salaam, Tanzania. Risk factors associated with significant fibrosis (APRI>0.5 and FIB-4 >1.45) were examined. Results 267 HIV-infected, 165 HBV-infected and 63 HIV/HBV co-infected patients were analyzed [44% male, median age 37 (IQR 14), BMI 23 (7)]. APRI and FIB-4 were strongly correlated (r = 0.78, p = < .001, R2 0.61). Overall median APRI scores were low [HIV/HBV [0.36 (IQR 0.4)], HIV [0.23 (0.17)], HBV [0.29 (0.15)] (p <0.01)]. In multivariate analyses, HIV/HBV co-infection was associated with APRI >0.5 [HIV/HBV vs. HIV: OR 3.78 (95% CI 1.91, 7.50)], [HIV/HBV vs. HBV: OR 2.61 (1.26, 5.44)]. HIV RNA per 1 log10 copies/ml increase [OR 1.53 (95% CI 1.04, 2.26)] and HBV DNA per 1 log10 copies/ml increase [OR 1.36 (1.15, 1.62)] were independently associated with APRI >0.5 in HIV-infected and HBV-infected patients, respectively. Conclusions HIV/HBV co-infection is an important risk factor for significant fibrosis. Higher levels of circulating HIV and HBV virus may play a direct role in liver fibrogenesis. Prompt diagnosis and aggressive monitoring of liver disease in HIV/HBV co-infection is warranted.

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Section: Discussionsupporting

confidence: 90%

Brief Report: HIV/HBV Coinfection is a Significant Risk Factor for Liver Fibrosis in Tanzanian HIV-Infected Adults

Hawkins

Christian

Fabian

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…In contrast to HIV/HCV co-infection, liver fibrosis mediated through apoptosis-related receptors do not play a key role in HIV/HBV co-infection. It has been hypothesized that HIV alters HBV-specific immune response by affecting the hepatic cytokine environment, thereby promoting liver fibrosis and disease progression; however, this hypothesis has not been thoroughly tested[69,70]. In HIV/HBV co-infection, it is difficult to determine the stage of liver disease[71].…”

Section: Hiv/hbv Co-infection-induced Liver Injurymentioning

confidence: 99%

Human immunodeficiency virus and hepatotropic viruses co-morbidities as the inducers of liver injury progression

Ganesan¹,

Poluektova²,

Kharbanda³

et al. 2019

WJG

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Hepatotropic viruses induced hepatitis progresses much faster and causes more liver- related health problems in people co-infected with human immunodeficiency virus (HIV). Although treatment with antiretroviral therapy has extended the life expectancy of people with HIV, liver disease induced by hepatitis B virus (HBV) and hepatitis C virus (HCV) causes significant numbers of non-acquired immune deficiency syndrome (AIDS)-related deaths in co-infected patients. In recent years, new insights into the mechanisms of accelerated fibrosis and liver disease progression in HIV/HCV and HIV/HBV co-infections have been reported. In this paper, we review recent studies examining the natural history and pathogenesis of liver disease in HIV-HCV/HBV co-infection in the era of direct acting antivirals (DAA) and antiretroviral therapy (ART). We also review the novel therapeutics for management of HIV/HCV and HIV/HBV co-infected individuals.

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“…In HIV-infected individuals, there is dysregulation of the TLR4 response to LPS ex-vivo [161] . As the liver is the first organ to filter blood from the GI tract, the concentrations of LPS in the portal veins is elevated and Kupffer cells have a “tolerised” or reduced response to LPS [162] . We have demonstrated persistently elevated levels of circulating LPS in HIV-HBV co-infected individuals compared to uninfected controls and HBV mono-infected individuals [163] , however, we did not find a direct correlation between elevated circulating LPS and liver fibrosis consistent with similar studies in HIV-HCV co-infection [164–166] .…”

Section: Pathogenesismentioning

confidence: 99%

HIV-hepatitis B virus coinfection

Singh¹,

Crane

Audsley

et al. 2017

Aids

191

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HIV infection has a significant impact on the natural history of chronic HBV infection, with increased levels of HBV DNA, accelerated progression of liver disease and increased liver-associated mortality compared to HBV mono-infection. Widespread uptake and early initiation of HBV-active antiretroviral therapy (ART) has substantially improved the natural history of HIV-HBV co-infection but the prevalence of liver disease remains elevated in this population. In this paper, we review recent studies examining the natural history and pathogenesis of liver disease and seroconversion in HIV-HBV co-infection in the era of HBV-active ART and the effects of HIV directly on liver disease. We also review novel therapeutics for the management of HBV with a particular emphasis on clinical strategies being developed for an HBV cure and an HIV cure and their impact on HIV-HBV co-infected individuals.

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Mechanisms of Accelerated Liver Fibrosis Progression during HIV Infection

Cited by 29 publications

References 95 publications

Brief Report: HIV/HBV Coinfection is a Significant Risk Factor for Liver Fibrosis in Tanzanian HIV-Infected Adults

Brief Report: HIV/HBV Coinfection is a Significant Risk Factor for Liver Fibrosis in Tanzanian HIV-Infected Adults

Human immunodeficiency virus and hepatotropic viruses co-morbidities as the inducers of liver injury progression

HIV-hepatitis B virus coinfection

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