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Serum levels of soluble cellular adhesion molecules are associated with survival and liver-related events in adults coinfected with HIV/HCV
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REported by Jules Levin
ICAAC 2014 Sept 5-9 Wash DC
T. Aldamiz-Echevarría1, S. Resino2, P. Miralles1, D. Pineda-Tenor2, A. Carrero1, M. Guzman-Fulgencio2, C. Díez1, F. Tejerina1, J.M. Bellon1, J. Berenguer1
1Hospital General Universitario Gregorio Marañón (IiSGM), Madrid, Spain, 2Instituto de Salud Carlos III, Majadahonda, Spain
Program Abstract:
Background: We have shown an association between advanced liver fibrosis and higher serum levels of soluble cellular adhesion molecules (sCAMs) (sICAM-1 and sVCAM-1) in HIV/HCV+ patients (Pts) (AIDS 2010; 24: 2059-67). Here we assess the relationship of serum levels of these cytokines with overall survival (OS) and liver-related events (LRE) in this population group.
Methodology: We analyzed a cohort of HIV/HCV+ Pts. with a liver biopsy (LB) and a baseline frozen serum sample taken the same day of the LB. Fibrosis was staged according to METAVIR. sCAMs were determined by immunoassay. We calculated the AUROCs of serum levels (Log ng/mL) of sCAMs to predict overall survival (OS) and LRE (decompensation or HCC, whichever occurred first). The optimal cutoff values (OCV) of sCAMs were the values with the highest combination of sensitivity and specificity for LRE. Adjusted Cox regression models (age, IDU, advanced fibrosis, CD4+ cells, cART, and SVR following IFN-RBV) were used to assess the adjusted hazard ratios (aHR) of serum levels of sCAMs above the OCV with OS and LRE.
Results: We studied 128 Pts.: male, 94; median age, 39 yr.; IDU, 114; CDC category C, 39; cART, 122; median CD4+ count, 462 cells/mm3; HIV-RNA < 50 copies/mL, 97; advanced fibrosis (F3-F4), 48; SVR following IFN-RBV after liver biopsy, 42. After a median FU of 133 months, 20 were lost to FU, 16 had a LRE, 12 died, and 11 had a new C event. AUROCs and aHR of CAMs for OS and LRE are shown in the table. OCV were 5.684 Log ng/mL for sICAM-1, and 6.229 Log ng/mL for sVCAM-1. TABLE 1
Conclusions: We found an association between higher serum levels of sCAMS with survival and LRE in HIV/HCV+ Pts. Increased serum levels of these cytokines may be a marker of inflammation and endothelial dysfunction that may negatively influence on HIV, HCV, and other comorbidities
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