HIV感染、HCV感染及HIV/HCV合并感染中的肝纤维化、微生物易位和免疫激活标志物

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

作者信息

Sacchi Paolo, Cima Serena, Corbella Marta, Comolli Giuditta, Chiesa Antonella, Baldanti Fausto, Klersy Catherine, Novati Stefano, Mulatto Patrizia, Mariconti Mara, Bazzocchi Chiara, Puoti Massimo, Pagani Laura, Filice Gaetano, Bruno Raffaele

机构信息

Department of Infectious Diseases, University of Pavia, IRCCS Policlinico San Matteo, Pavia, Italy.

Molecular and Virology Unit, IRCCS Policlinico San Matteo, Pavia, Italy; Laboratory of Biotechnology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

出版信息

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

DOI:10.1016/j.dld.2014.11.012

PMID:25544657

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.

摘要

背景

人类免疫缺陷病毒和丙型肝炎病毒合并感染的患者肝纤维化进程加快。

目的

我们研究了肝纤维化、免疫激活与微生物易位之间的相关性。

方法

这项横断面研究纳入了丙型肝炎病毒（HCV）单感染、人类免疫缺陷病毒（HIV）单感染、HIV/HCV合并感染的患者以及健康对照（每组20名受试者）。分析外周血以确定叉头框3（Foxp3）T细胞、转化生长因子-β1（TGF-β1）、CD14（可溶性和表面异构体）、白细胞介素-17（IL-17）水平以及细菌易位产物。这些测量结果与通过FIB-4评分和瞬时弹性成像测量的肝纤维化严重程度相关。

结果

HIV单感染组和合并感染组的Foxp3 T细胞水平显著升高（p<0.0005）。FIB-4和肝脏硬度值与TGF-β1呈负相关（p=0.0155和p=0.0498）。与其他组相比，HIV阳性组的细菌DNA有显著差异：HIV/HCV合并感染的受试者血清中的细菌易位产物、CD14和IL-17水平显著更高（p<0.001）。