Bacterial translocation and clinical progression of HCV-related cirrhosis in HIV-infected patients

J Viral Hepat. 2018 Feb;25(2):180-186. doi: 10.1111/jvh.12769. Epub 2017 Sep 7.

Abstract

The aim of the study was to evaluate whether bacterial translocation (BT) predicts the clinical outcome in HIV/HCV-coinfected patients with compensated cirrhosis. A cohort of 282 HIV/HCV-coinfected patients with cirrhosis and no previous liver decompensation (LD) was recruited. Serum levels of the DNA sequences encoding the well-conserved 16S rRNA subunit (16S rDNA), the lipopolysaccharide (LPS) and soluble CD14 (sCD14) at diagnosis of cirrhosis were measured. Primary endpoint was the emergence of the first LD and/or death of any cause. Secondary endpoints were LD, liver-related death (LRD) and death of any cause. After a median (Q1-Q3) follow-up of 51 (27-72) months, 67 patients (24%; 95% CI: 19-29) developed their first LD or died during follow-up. Baseline levels of 16S rDNA, LPS and sCD14 were not associated with the probability of developing the primary endpoint of the study. The mean (SD) survival time free of LD and/or death according to levels of 16S rDNA (<83, 83-196, 197-355, >355 [copies/μL]) was 78 (5), 72 (5), 81 (4) and 82 (4) months, respectively (P = .5). The corresponding figures for LPS (<0.1, 0.1-0.6, 0.6-1.5, > 1.5 [IU/mL]) were 76 (5), 71 (5), 77 (5) and 81 (4) months, respectively (P = .4). Baseline levels of BT serum markers were not associated with any of the secondary endpoints analysed in the study. Thus, BT does not seem to be a relevant predictor of clinical outcome in HIV/HCV-coinfected patients with compensated cirrhosis.

Keywords: bacterial translocation; hepatitis C virus; human immunodeficiency virus; liver cirrhosis; spontaneous bacterial peritonitis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bacterial Infections / blood
  • Bacterial Translocation*
  • Biomarkers / blood*
  • Coinfection / microbiology
  • Coinfection / virology*
  • Female
  • HIV Infections / complications*
  • Hepacivirus
  • Hepatitis C / complications
  • Hepatitis C / microbiology*
  • Hepatitis C / mortality
  • Humans
  • Lipopolysaccharide Receptors / blood
  • Lipopolysaccharides / blood
  • Liver Cirrhosis / mortality
  • Liver Cirrhosis / virology*
  • Male
  • Middle Aged
  • Peritonitis / microbiology
  • Prospective Studies
  • RNA, Ribosomal, 16S / blood
  • Retrospective Studies

Substances

  • Biomarkers
  • Lipopolysaccharide Receptors
  • Lipopolysaccharides
  • RNA, Ribosomal, 16S