Department of Pathology and Laboratory Medicine, University of Louisville, Louisville, KY, United States.
Division of Infectious Diseases, Department of Medicine, Georgetown University, Washington, District of Columbia, United States.
Cytokine. 2021 Aug;144:155573. doi: 10.1016/j.cyto.2021.155573. Epub 2021 May 12.
The prevalence of non-alcoholic fatty liver disease (NAFLD) is higher in HIV-infected patients compared to the general population. While metabolic risk factors such as obesity, insulin resistance and the metabolic syndrome have been identified as key risk factors in all individuals, there is limited information regarding the mechanisms that contribute to the higher prevalence among individuals living with HIV, particularly among women and ethnic minorities. The aim of this study was to determine the association, over two time points, of a panel of biomarkers with liver steatosis in a cohort of HIV-seropositive women and age-matched negative controls and to investigate whether the association differed by HIV status. To this effect, plasma samples obtained from 105 HIV-positive and -negative participants enrolled in the Women's Interagency HIV study (WIHS) Washington DC site were assayed for biomarkers associated with inflammation, adipose tissue function, fibrinolysis, gut permeability and hepatocyte apoptosis/necrosis. Their association with liver steatosis, measured using Controlled-Attenuation Parameter (CAP) scores determined by transient elastography, were then analyzed. HIV positivity was associated with lower median IL-17A and higher IL-22 and sCD14 values. There were no statistically significant associations between HIV status, biomarkers or covariates with CAP measurement over two time points. However, IL-1β levels were associated with higher CAP scores at the second visit. Across all statistical models, an increase in BMI was associated with an increase in CAP measurements. No statistically significant associations were found between viral load history, CD4 + T-cell count, biomarkers and covariates, including ART use, on CAP measurements. These results confirm that BMI is a key risk factor for liver steatosis independent of HIV status. The potential contributions to NAFLD of differences in IL-1β, Th17-family cytokines and gut permeability between HIV-positive vs. negative individuals require further study.
非酒精性脂肪性肝病（NAFLD）在感染 HIV 的患者中的患病率高于普通人群。虽然代谢危险因素，如肥胖、胰岛素抵抗和代谢综合征已被确定为所有个体的关键危险因素，但对于导致 HIV 感染者患病率升高的机制，特别是对于女性和少数民族，信息有限。本研究的目的是确定在 HIV 阳性妇女和年龄匹配的阴性对照者队列中，一组生物标志物与肝脂肪变性的关联，并研究这种关联是否因 HIV 状态而异。为此，从参加妇女机构间 HIV 研究（WIHS）华盛顿特区站点的 105 名 HIV 阳性和阴性参与者中获得的血浆样本，用于测定与炎症、脂肪组织功能、纤维蛋白溶解、肠道通透性和肝细胞凋亡/坏死相关的生物标志物。然后分析它们与使用瞬态弹性成像确定的受控衰减参数（CAP）评分测量的肝脂肪变性的相关性。HIV 阳性与较低的 IL-17A 中位数和较高的 IL-22 和 sCD14 值相关。在两个时间点，HIV 状态、生物标志物或协变量与 CAP 测量之间没有统计学上的显著关联。然而，IL-1β 水平与第二次就诊时的 CAP 评分较高相关。在所有统计模型中，BMI 的增加与 CAP 测量值的增加相关。在 CAP 测量中，未发现病毒载量史、CD4+T 细胞计数、生物标志物和协变量（包括 ART 使用）之间存在统计学显著关联。这些结果证实 BMI 是独立于 HIV 状态的肝脂肪变性的关键危险因素。需要进一步研究 HIV 阳性与阴性个体之间 IL-1β、Th17 细胞因子和肠道通透性的差异对 NAFLD 的潜在贡献。
