Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
Unidad de Análisis Clínicos, Fundación Hospital Alcorcón, Alcorcón, Madrid, Spain.
Sci Rep. 2020 Jun 25;10(1):10384. doi: 10.1038/s41598-020-67159-3.
We aimed to evaluate the association of plasma biomarkers linked to inflammation (bacterial translocation, inflammatory response, and endothelial dysfunction), coagulopathy, and angiogenesis with the severity of liver cirrhosis (assessed by the Child-Pugh-Turcotte score, CTP) and Child-Pugh B cirrhosis (CTP 7-9) in patients with advanced hepatitis C virus (HCV)-related cirrhosis. We carried out a cross-sectional study in 97 patients with advanced HCV-related cirrhosis (32 HCV-monoinfected and 65 HIV/HCV-coinfected). Plasma biomarkers were measured by ProcartaPlex multiplex immunoassays. The outcome variable was the CTP score and the Child-Pugh B cirrhosis (CTP 7-9). HIV/HCV-coinfected patients and HCV-monoinfected patients with advanced HCV-related cirrhosis had near-equivalent values of plasma biomarkers. Higher values of plasma biomarkers linked to an inflammatory response (IP-10, IL-8, IL-6, and OPG), endothelial dysfunction (sVCAM-1 and sICAM-1), and coagulopathy (D-dimer) were related to higher CTP values. The most significant biomarkers to detect the presence of Child-Pugh B cirrhosis (CTP 7-9) were IP-10 (p-value= 0.008) and IL-6 (p-value=0.002). The AUC-ROC values of IP-10, IL-6, and both biomarkers combined (IP-10+IL-6) were 0.78, 0.88, and 0.96, respectively. In conclusion, HIV infection does not appear to have a significant impact on the analyzed plasma biomarkers in patients with advanced HCV-related cirrhosis. However, plasma biomarkers linked to inflammation (inflammatory response and endothelial dysfunction) were related to the severity of liver cirrhosis (CTP score), mainly IP-10 and IL-6, which discriminated patients with Child-Pugh B concerning Child-Pugh A.
我们旨在评估与炎症（细菌易位、炎症反应和内皮功能障碍）、凝血异常和血管生成相关的血浆生物标志物与晚期丙型肝炎病毒（HCV）相关肝硬化患者的肝硬化严重程度（通过 Child-Pugh-Turcotte 评分，CTP）和 Child-Pugh B 肝硬化（CTP 7-9）的相关性。我们对 97 例晚期 HCV 相关肝硬化患者（32 例 HCV 单感染和 65 例 HIV/HCV 合并感染）进行了横断面研究。通过 ProcartaPlex 多重免疫分析测量血浆生物标志物。结局变量为 CTP 评分和 Child-Pugh B 肝硬化（CTP 7-9）。HIV/HCV 合并感染患者和 HCV 单感染患者的晚期 HCV 相关肝硬化患者的血浆生物标志物值相近。与炎症反应（IP-10、IL-8、IL-6 和 OPG）、内皮功能障碍（sVCAM-1 和 sICAM-1）和凝血异常（D-二聚体）相关的血浆生物标志物水平较高与较高的 CTP 值相关。检测 Child-Pugh B 肝硬化（CTP 7-9）存在的最显著的生物标志物是 IP-10（p 值=0.008）和 IL-6（p 值=0.002）。IP-10、IL-6 和两者联合生物标志物（IP-10+IL-6）的 AUC-ROC 值分别为 0.78、0.88 和 0.96。总之，HIV 感染似乎不会对晚期 HCV 相关肝硬化患者的分析血浆生物标志物产生重大影响。然而，与炎症（炎症反应和内皮功能障碍）相关的血浆生物标志物与肝硬化的严重程度（CTP 评分）相关，主要是 IP-10 和 IL-6，它们可以区分 Child-Pugh B 与 Child-Pugh A 患者。
