scholarly journals Dysregulation of the Immune System in HIV/HCV-Coinfected Patients According to Liver Stiffness Status

Cells ◽  
2018 ◽  
Vol 7 (11) ◽  
pp. 196 ◽  
Author(s):  
Pilar Garcia-Broncano ◽  
Luz Medrano ◽  
Juan Berenguer ◽  
Juan González-García ◽  
Mª Jiménez-Sousa ◽  
...  
Keyword(s):  
Transient Elastography ◽  
Liver Stiffness ◽  
Cross Sectional Study ◽  
T Cell Subsets ◽  
Cross Sectional ◽  
Plasma Cytokine ◽  
Advanced Cirrhosis ◽  
Healthy Donors ◽  
Tnf Α ◽  
Cytokine Levels

Background: Advanced cirrhosis is related to alterations in immunity. We aimed to evaluate the levels of peripheral CD4+ T cells (Tregs) and plasma cytokine in patients coinfected with human immunodeficiency virus and hepatitis C virus (HIV/HCV) according to liver fibrosis stages [evaluated as liver stiffness measure (LSM)] and their linear relationship. Methods: We performed a cross-sectional study on 238 HIV/HCV-coinfected patients (119 had <12.5 kPa, 73 had 12.5–25 kPa, and 46 had >25 kPa). Peripheral T-cell subsets were phenotyped by flow cytometry, plasma biomarkers were assessed by multiplex immunoassays, and LSM was assessed by transient elastography. Results: We found HIV/HCV-coinfected patients had higher values of CD4+ Tregs (p < 0.001), memory Tregs (p ≤ 0.001), and plasma cytokine levels [IFN-γ (p ≤ 0.05) and IL-10 (p ≤ 0.01)] compared with healthy donors and HIV-monoinfected patients. In the multivariate analysis, higher LSM values were associated with reduced levels of IL-10 (adjusted arithmetic mean ratio (aAMR) = 0.83; p = 0.019), IL-2 (aAMR = 0.78; p = 0.017), TNF-α (aAMR = 0.67; p < 0.001), and IL-17A (aAMR = 0.75; p = 0.006). When we focus on HIV/HCV-coinfected patients analyzed by LSM strata, patients with ≥25 kPa had lower values of IL-2 (aAMR = 0.66; p = 0.021), TNF-α (aAMR = 0.565; p = 0.003), and IL-17A (aAMR = 0.58; p = 0.003) than patients with <12.5 kPa. Conclusion: HIV/HCV-coinfected patients showed an immunosuppressive profile compared to healthy controls and HIV-monoinfected patients. Additionally, HIV/HCV-coinfected patients with advanced cirrhosis (LSM ≥ 25 kPa) had the lowest plasma values of cytokines related to Th1 (IL-2 and TNF-α) and Th17 (IL-17A) response.

scholarly journals Hepatic fibrosis and factors associated with liver stiffness in HIV mono-infected individuals

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e2867
Author(s):  
Mihály Sulyok ◽  
Tamás Ferenci ◽  
Mihály Makara ◽  
Gábor Horváth ◽  
János Szlávik ◽  
...  
Keyword(s):  
Hepatic Fibrosis ◽  
Bayesian Model Averaging ◽  
Hepatitis Virus ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Model Averaging ◽  
Positive Association ◽  
Cross Sectional Study ◽  
Cross Sectional

BackgroundLiver disease has become an important cause of morbidity and mortality even in those HIV-infected individuals who are devoid of hepatitis virus co-infection. The aim of this study was to evaluate the degree of hepatic fibrosis and the role of associated factors using liver stiffness measurement in HIV mono-infected patients without significant alcohol intake.MethodsWe performed a cross-sectional study of 101 HIV mono-infected patients recruited prospectively from March 1, 2014 to October 30, 2014 at the Center for HIV, St István and St László Hospital, Budapest, Hungary. To determine hepatic fibrosis, liver stiffness was measured with transient elastography. Demographic, immunologic and other clinical parameters were collected to establish a multivariate model. Bayesian Model Averaging (BMA) was performed to identify predictors of liver stiffness.ResultsLiver stiffness ranged from 3.0–34.3 kPa, with a median value of 5.1 kPa (IQR 1.7). BMA provided a very high support for age (Posterior Effect Probability-PEP: 84.5%), moderate for BMI (PEP: 49.3%), CD4/8 ratio (PEP: 44.2%) and lipodystrophy (PEP: 44.0%). For all remaining variables, the model rather provides evidence against their effect. These results overall suggest that age and BMI have a positive association with LS, while CD4/8 ratio and lipodystrophy are negatively associated.DiscussionOur findings shed light on the possible importance of ageing, overweight and HIV-induced immune dysregulation in the development of liver fibrosis in the HIV-infected population. Nonetheless, further controlled studies are warranted to clarify causal relations.

scholarly journals Liver stiffness by transient elastography accompanies illness severity in COVID-19

2020 ◽  
Vol 7 (1) ◽  
pp. e000445
Author(s):  
Maria Effenberger ◽  
Christoph Grander ◽  
Gernot Fritsche ◽  
Rosa Bellmann-Weiler ◽  
Frank Hartig ◽  
...  
Keyword(s):  
Liver Damage ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Gastrointestinal Symptoms ◽  
Severity Of Illness ◽  
Cross Sectional Study ◽  
Illness Severity ◽  
University Hospital ◽  
Cross Sectional ◽  
Severe Liver Damage

ObjectiveSevere liver damage is associated with worse outcome in COVID-19. Our aim was to explore the degree of liver damage, liver stiffness (LS) and severity of illness in patients with COVID-19.DesignWe investigated 32 patients with COVID-19 admitted to the University Hospital of Innsbruck in a prospective cross-sectional study. We performed laboratory testing, liver and spleen sonography and elastography to measure organ stiffness.Results12 patients (38%) showed elevated aminotransferases and gamma-glutamyltransferase levels. LS was positively correlated with elevated aminotransferase levels in patients with COVID-19 compared with those without elevated enzymes. Even mild liver damage raised LS significantly in COVID-19 as it was in patients with gastrointestinal symptoms. Furthermore, higher LS measurements were significantly associated with illness severity like pneumonia, need for mechanical ventilation, and even death.ConclusionTransient elastography is a useful and non-invasive tool to assess onset and severity of acute liver injury in patients with COVID-19 patients. Increased LS seems to be predictive for a more severe and complicated course of disease.

scholarly journals Liver Fibrosis and Steatosis in Virally Suppressed HIV-Infected Patients with Cytomegalovirus Seropositivity

2022 ◽  
Vol 22 (3) ◽  
pp. 180-187
Author(s):  
Chyntia Olivia Maurine Jasirwan ◽  
Adik Wibowo ◽  
Amal C Sjaaf ◽  
Gita Aprilicia ◽  
Dyah Purnamasari ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Clinical Presentation ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Human Herpesvirus ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Coefficient Corrélation ◽  
One Year

Background: Cytomegalovirus (CMV) is a human herpesvirus common in people with human immunodeficiency virus (HIV). In a patient with immunocompetence, long periodic asymptomatic CMV might affect to develop the abnormal liver function and contribute to non-AIDS defining morbidity, including chronic liver disease. This study aims to know the prevalence of liver fibrosis and steatosis in virally suppressed HIV infected patients with CMV reactive and summarize the correlation of clinical presentation with liver fibrosis and steatosis in these subjects.Method: A cross-sectional study in HIV Integrated Care Unit, Cipto Mangunkusumo Hospital, was conducted from April 2019 until June 2020. Subjects enrolled in this study were suppressed HIV patients aged between 30-40 years with positive IgG CMV and already using stable ART for at least one year. Transient elastography measured the liver stiffness. Patients with liver stiffness above 7 kPa were defined as having significant liver fibrosis. In addition, Spearman correlation was conducted to evaluate the correlation of clinical presentation of subjects related to liver fibrosis and steatosis. Results: A total of subjects was included in this study. Dominantly male (62.5%) with average age 38 ± 4.68 years. The median amount of CMV DNA was 466 (17-21284) copy/ml. Significant Fibrosis was found in 17/80 (21%) subjects. In this study, clinical parameters correlated with liver fibrosis were insulin, glucose fasting, Homa IR, triglyceride, HDL, and platelet. A medium positive correlation was found in insulin, and Homa IR, with coefficient correlation for insulin, was r = 0.475, p 0.001; and coefficient correlation for Homa IR was r = 0 .487, p 0.001.Conclusion: The prevalence of liver fibrosis was 12% in these subjects. In addition, insulin and Homa IR had a positive correlation with increasing liver fibrosis.

scholarly journals Prevalence of Elevated Liver Stiffness Among Potential Candidates for Bariatric Surgery in the United States

2022 ◽  
Author(s):  
Stefano Ciardullo ◽  
Mattia Pizzi ◽  
Pietro Pizzi ◽  
Alice Oltolini ◽  
Emanuele Muraca ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Liver Disease ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
The United States ◽  
Cross Sectional Study ◽  
Metabolic Dysfunction ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Using Data

Abstract Purpose Obesity represents a well-known risk factor for metabolic-dysfunction associated fatty liver disease (MAFLD) and its progression towards cirrhosis. The aim of this study is to estimate the proportion of potential candidates to a bariatric surgery intervention that has an elevated liver stiffness on vibration-controlled transient elastography (VCTE). Materials and Methods This is a cross-sectional study performed using data obtained during the 2017–2018 cycle of the National Health and Nutrition Examination Survey. Potential candidates for a bariatric surgery intervention from the general US population were identified by applying criteria from international guidelines. All included participants were evaluated by VCTE. A controlled attenuation parameter (CAP) value ≥ 288 dB/m was considered indicative of steatosis while liver stiffness measurement (LSM) was considered elevated if ≥ 9.7 kPa. Multivariable logistic regression models were fitted to identify independent predictors of both outcomes. Results A total of 434 participants were included (mean age 42.9 ± 0.6 years; 54.4% women). Among them, 76.7% (95% CI 71.7–81.0) had steatosis, while 23.1% (95% CI 17.8–29.3) had an elevated LSM. Male sex, older age, γ-glutamyltranspeptidase levels, and body mass index (BMI) were independent predictors of steatosis, while BMI was the only independent predictor of elevated LSM. Non-Hispanic black participants were protected from both outcomes, while other ethnicities were not. Conclusion The prevalence of elevated LSM is high in potential candidates for a bariatric surgery intervention. Accurate screening for occult advanced liver disease might be indicated in this patient population. Graphical abstract

scholarly journals Risk of Liver Fibrosis in Hepatitis B Virus and HIV Coinfected Youths Receiving Tenofovir-Containing Antiretroviral Regimen

2019 ◽  
Vol 18 ◽  
pp. 232595821882325 ◽  
Author(s):  
Linda Aurpibul ◽  
Suparat Kanjanavanit ◽  
Apinya Leerapun ◽  
Thanyawee Puthanakit
Keyword(s):  
Hepatitis B Virus ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Therapy Regimen ◽  
B Virus ◽  
Risk Of Progression

Background: Hepatitis B virus (HBV) and HIV coinfection is associated with risk of progression to chronic liver disease. We assessed liver stiffness in HBV-HIV coinfected youths. Methods: A cross-sectional study in HBV-HIV coinfected youths aged 18 to 25 years who received a tenofovir (TDF)-containing antiretroviral therapy regimen for >96 weeks. Measurements included HBV DNA level, HBV serology profiles, and transient elastography (TE). The cutoff for TE results included ≥5.9 kPa for F2-moderate fibrosis, ≥7.4 kPa for F3-severe fibrosis, and ≥9.6 kPa for F4-cirrhosis. Results: From March to December 2016, 15 HBV-HIV coinfected youths with a median duration on TDF-containing regimens of 3.3 years were enrolled. Five (33%) youths had significant liver fibrosis, 3 with F2-moderate, 1 with F3-advanced fibrosis, and 1 with F4-cirrhosis. Other 5 without liver fibrosis had hepatitis B surface e antigen (HBsAg) and hepatitis B surface e antigen (HBeAg) loss. Higher mean alanine transaminase (ALT) was observed among the group with F2-F4 when compared to those with F0. Conclusion: Liver fibrosis was evidenced in HBV-HIV coinfected youths in Thailand. Transient elastography might be considered for those who do not achieve HBsAg loss or have persistent ALT elevation while on treatment.

scholarly journals Usefulness of fibro scan in assessing liver fibrosis in adult patients with psoriasis

2019 ◽  
Vol 5 (2) ◽  
pp. 376
Author(s):  
Parimalam Kumar ◽  
Suchithra Ganapathi ◽  
Athilakshmi Sivasubramanian
Keyword(s):  
Liver Fibrosis ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Cross Sectional Study ◽  
Adult Patients ◽  
Correct Treatment ◽  
Cross Sectional ◽  
Alcoholic Fatty Liver ◽  
Psoriatic Arthropathy ◽  
Gender Influence

<p class="abstract"><strong>Background:</strong> Patients with psoriasis are at higher risk of developing “systemic” co-morbidities. Non alcoholic fatty liver disease (NAFLD) is found to be more prevalent among psoriasis patients, where it is closely associated with obesity, metabolic syndrome, and psoriatic arthropathy. Elderly participants with psoriasis are 70% more likely to have NAFLD than those without psoriasis independent of common NAFLD risk factors.Methotrexate is a commonly used drug in the management of psoriasis owing to its cost effectiveness and easy administration. In the presence of NAFLD the choice of potentially hepatotoxic drug therapy, such as methotrexate, should be considered with caution. By assessing the liver stiffness measurement (LSM), such drugs can be prescribed with caution in individual with significant liver fibrosis. We have conducted a study to assess the LSM in patients with psoriasis. Aim was to detect the proportion of liver fibrosis (LSM) in adult patients with psoriasis, which will help in choosing the correct treatment.</p><p class="abstract"><strong>Methods:</strong> Hospital based cross sectional study was conducted in 102 adults with psoriasis who were not treated with methotrexate. Transient elastography (TE) was performed in all and LSM was noted.<strong></strong></p><p class="abstract"><strong>Results:</strong> There was no statistically significant gender influence on LSM in patients with psoriasis. There was significant increase in liver fibrosis in psoriatic patients as age advances.</p><p class="abstract"><strong>Conclusions:</strong> Elderly patients with psoriasis are more likely to have liver fibrosis. Hepatotoxic drugs like methotrexate should be prescribed with caution in such patients, preferably after performing LSM.</p>

scholarly journals Association between behavioural risk factors for chronic liver disease and transient elastography measurements across the UK: a cross-sectional study

2020 ◽  
Vol 7 (1) ◽  
pp. e000524
Author(s):  
Ceyhun Aksel Oztumer ◽  
Rayhan Mehmood Chaudhry ◽  
Laith Alrubaiy
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Alcohol Consumption ◽  
Viral Hepatitis ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Uk

ObjectiveChronic liver disease (CLD) is a largely preventable condition with increasing burden on National Health Service resources. We aimed to determine the prevalence of behavioural risk factors for CLD and their association with liver stiffness and socioeconomic status in the UK.DesignIn this cross-sectional study, adults aged ≥18 years were invited to complete a liver health screener and have a liver stiffness measurement (LSM) by transient elastography (TA) to screen for alcohol intake, obesity and viral hepatitis risk across different areas in the UK. Index of Multiple Deprivation (IMD) scores were used as a measure of socioeconomic status. We performed binary logistic regression, adjusting for age, gender, alcohol consumption, body mass index, diet and viral hepatitis risk to determine the factors associated with LSM and IMD.ResultsWe analysed the data from 2150 individuals across 25 UK areas. Of those, 24.1% had high-risk alcohol consumption, 29.6% had high-risk diets, 24.7% were obese and 32.7% had risk factors for viral hepatitis. LSMs were available for 1043 participants, of which 16.2% were ≥7 kPa. Independent predictors of an LSM≥7 kPa were an age≥40 years (OR, 1.986; 95% CI, 1.280 to 3.081), male gender (OR, 1.599; 95% CI, 1.128 to 2.266), obesity (OR, 2.526; 95% CI, 1.383 to 4.614) and high-risk diet (OR, 2.197; 95% CI, 1.000 to 4.826). Five-unit increases in IMD score were an independent predictor of obesity (OR, 1.110; 95% CI, 1.028 to 1.200), but not high-risk alcohol consumption (p=0.88) or viral hepatitis risk (p=0.05).ConclusionsWe identified a high prevalence of risk factors for CLD, most of which are addressable through raising public awareness to inculcate healthy habits. More studies are needed to assess longitudinal outcomes of liver screening using TA, accounting for societal factors and comorbidities, to help inform resource allocation and policy-making in the future.

Can Cytokines be used as an Activation Marker in Rheumatoid Arthritis?

2020 ◽  
Vol 20 ◽  
Author(s):  
Fatih Öner Kaya ◽  
Yeşim Ceylaner ◽  
Belkız Öngen İpek ◽  
Zeynep Güneş Özünal ◽  
Gülbüz Sezgin ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Healthy Volunteers ◽  
Venous Blood ◽  
Cross Sectional Study ◽  
Joint Disease ◽  
Control Group ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Das 28 ◽  
Tnf Α

Aims: The etiopathogenesis of Rheumatoid Arthritis (RA) is not clearly understood. However, the role of the cytokines takes an important part in this mechanism. We aimed to bring a new approach to the concept of 'remission' in patients with RA. Background: RA is a chronic, autoimmune, inflammatory disease that involves small joints in the form of symmetrical polyarthritis and progresses with exacerbations and remissions. Pain, swelling, tenderness and morning stiffness are typical of the joints involved. Although it is approached as a primary joint disease, a wide variety of extra-articular involvements may also occur. It is an interesting pathophysiological process, the exact cause of which is still unknown, with many environmental, genetic and potentially undiscovered possible factors in a chaotic manner. Objective: In this cross-sectional study, sedimentation rate (ESR), C- Reactive protein (CRP), Tumor necrosis factor (TNF)-α, soluble-TNF-α receptor (TNF-R), Interleukin (IL)-1B and IL-10 were measured in three groups which were healthy volunteers, patients with RA in the active period, and patients with RA in remission. Disease activity score-28 (DAS-28) was calculated in active RA and RA in remission. Methods: This study included 20 healthy volunteers, 20 remission patients with RA and 20 active RA patients. Venous blood samples were collected from patients in both healthy and RA groups. Results: RA group consisted 43 (71.6%) female and 17 (28.4%) male. Control group consisted 11 (55%) female and 9 (45%) male. TNF-R was significantly high only in the active group according to the healthy group (p=0.002). IL-10 was significantly high in active RA according to RA in remission (p=0.03). DAS-28 was significantly high in active RA according to RA in remission (p=0.001). In the active RA group, ESR and TNF-R had a positive correlation (r:0.442; p=0.048). In the active RA group, there was also a positive correlation between TNF-R and CRP (r:0.621; p=0,003). Both healthy and active RA group had significant positive correlation between ESR and CRP (r: 0.481; p=0.032 and r: 0,697; p=0,001 respectively). Conclusion: TNF-R can be the main pathophysiological factor and a marker showing activation. TNF-R can be very important in revealing the effect of TNF on the disease and the value of this effect in the treatment and ensuring the follow-up of the disease with CRP instead of ESR in activation.

scholarly journals A Cross-Sectional Study of Bitter-Taste Receptor Genotypes, Oral Health, and Markers of Oral Inflammation

Oral ◽  
2021 ◽  
Vol 1 (2) ◽  
pp. 122-138
Author(s):  
Kiranjit Kaur ◽  
Alexandria Turner ◽  
Patrice Jones ◽  
Dean Sculley ◽  
Martin Veysey ◽  
...  
Keyword(s):  
Oral Health ◽  
Bitter Taste ◽  
Taste Receptor ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Bitter Taste Receptor ◽  
Cross Sectional ◽  
Tnf Α ◽  
Oral Inflammation ◽  
Major Allele

(1) Background: The aetiology of oral disease is multifactorial, involving genetic and environmental factors, including dietary ones. Bitter taste genetics may be related to oral health through dietary modulation or non-gustatory roles, including modulation of inflammation. Investigations of bitter taste and oral health associations to date have been restricted to specific polymorphisms, limited outcomes (caries), and age-groups (children), and links to inflammation remain to be elucidated. (2) Methods: A cross-sectional study (n = 65) investigated the correlations between bitter taste genotypes, oral health outcomes, and oral inflammation markers. Oral examinations were conducted, including saliva testing with evaluation of flow rate, pH, and buffering and antioxidant capacity (FRAP) and IL-1β, TNF-α, IL-6 levels. DNA was collected via buccal swabs and used to evaluate the presence of multiple bitter-taste receptor gene polymorphisms. (3) Results: The major allele for TAS2R4-rs2233998, TAS2R5-rs2227264, TAS2R50-rs1376251, and TAS2R9-rs3741845 was associated with a higher mean of unstimulated salivary flow rate, FRAP, TNF-α, IL-1β, and likelihood of filled teeth. Presence of the major allele for TAS2R4-rs2234001 and TAS2R9-rs3741845 was associated with lower means FRAP, TNF-α, IL-1β, DMFT index, and likelihood of missing teeth. (4) Conclusions: These findings suggest relationships between bitter-taste genotypes, oral health outcomes, and inflammatory markers. These findings justify the need for further studies that could help identify risk groups and develop novel agents for maintaining oral health.

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