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Gawrieh S, Vilar-Gomez E, Woreta TA, Lake JE, Wilson LA, Price JC, Naggie S, Sterling RK, Heath S, Corey KE, Cachay ER, Ajmera V, Tonascia J, Sulkowski MS, Chalasani N, Loomba R. Prevalence of steatotic liver disease, MASLD, MetALD and significant fibrosis in people with HIV in the United States. Aliment Pharmacol Ther 2024; 59:666-679. [PMID: 38158589 PMCID: PMC10922859 DOI: 10.1111/apt.17849] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/14/2023] [Accepted: 12/14/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Metabolic dysfunction-associated steatotic liver disease (MASLD) has recently been proposed as a replacement term for NAFLD. AIMS To assess the effects of this new nomenclature on the prevalence and distribution of different SLD categories in people with HIV (PWH) and identified factors associated with MASLD and clinically significant fibrosis (CSF). METHODS PWH were prospectively enrolled from 9 US centres and underwent clinical evaluation and vibration-controlled transient elastography for controlled attenuation parameter (CAP) and liver stiffness measurement (LSM). SLD was defined as CAP ≥ 263 dB/m, CSF as LSM of ≥8 kPa, and advanced fibrosis (AF) as LSM ≥ 12 kPa. The prevalence of SLD, MASLD, metabolic dysfunction and alcohol-associated liver disease (MetALD), ALD, cryptogenic (cSLD), CSF and AF were determined. Uni- and multivariate logistic regression models were used to assess factors associated with MASLD and CSF risk. RESULTS Of 1065 participants, 74% were male, mean (SD) age 51.6 ± 11.9 years, 46% non-Hispanic Black and 74% with undetectable HIV RNA. The prevalence of SLD was 52%, MASLD 39%, MetALD 10%, ALD 3%, CSF 15% and AF 4%. Only 0.6% had cSLD. Black race was protective whereas obesity, ALT and AST levels were associated with increased risk of MASLD and CSF in MASLD. HIV or antiretroviral therapy did not affect MASLD risk. CONCLUSIONS MASLD and MetALD are the dominant causes of SLD in PWH, affecting almost half. Application of the new nomenclature resulted in minimal change in the proportion of patients with MASLD who would have been diagnosed previously with NAFLD.
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Affiliation(s)
- Samer Gawrieh
- Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN
| | - Eduardo Vilar-Gomez
- Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN
| | - Tinsay A. Woreta
- Division of Division of Gastroenterology and Hepatology, John Hopkins University, Baltimore, MD
| | - Jordan E. Lake
- Division of Infectious Diseases, Department of Medicine, UTHealth, Houston, Houston, TX
| | - Laura A. Wilson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Jennifer C Price
- Division of Gastroenterology and Hepatology, University of California, San Francisco, CA
| | - Susanna Naggie
- Division of Infectious Diseases, Duke University School of Medicine, Durham, NC
| | - Richard K. Sterling
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, VA
| | - Sonya Heath
- Division of Infectious Diseases, University of Alabama, Birmingham, AL
| | - Kathleen E. Corey
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Edward R Cachay
- Division of Infectious Diseases and Global Public Health, University of California, San Diego, CA
| | - Veeral Ajmera
- Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, CA
| | - James Tonascia
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Mark S. Sulkowski
- Division of Infectious Diseases, John Hopkins University, Baltimore, MD
| | - Naga Chalasani
- Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN
| | - Rohit Loomba
- Division of Gastroenterology and Hepatology, University of California at San Diego, La Jolla, CA
- The Herbert Wertheim School of Public Health and Human Longevity Science, University of California at San Diego, La Jolla, CA
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Gawrieh S, Lake JE, Debroy P, Sjoquist JA, Robison M, Tann M, Akisik F, Bhamidipalli SS, Saha CK, Zachary K, Robbins GK, Gupta SK, Chung RT, Chalasani N, Corey KE. Burden of fatty liver and hepatic fibrosis in persons with HIV: A diverse cross-sectional US multicenter study. Hepatology 2023; 78:578-591. [PMID: 36805976 PMCID: PMC10496090 DOI: 10.1097/hep.0000000000000313] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 01/02/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND AIMS The current prevalence of fatty liver disease (FLD) due to alcohol-associated (AFLD) and nonalcoholic (NAFLD) origins in US persons with HIV (PWH) is not well defined. We prospectively evaluated the burden of FLD and hepatic fibrosis in a diverse cohort of PWH. APPROACH RESULTS Consenting participants in outpatient HIV clinics in 3 centers in the US underwent detailed phenotyping, including liver ultrasound and vibration-controlled transient elastography for controlled attenuation parameter and liver stiffness measurement. The prevalence of AFLD, NAFLD, and clinically significant and advanced fibrosis was determined. Univariate and multivariate logistic regression models were used to evaluate factors associated with the risk of NAFLD. Of 342 participants, 95.6% were on antiretroviral therapy, 93.9% had adequate viral suppression, 48.7% (95% CI 43%-54%) had steatosis by ultrasound, and 50.6% (95% CI 45%-56%) had steatosis by controlled attenuation parameter ≥263 dB/m. NAFLD accounted for 90% of FLD. In multivariable analysis, old age, higher body mass index, diabetes, and higher alanine aminotransferase, but not antiretroviral therapy or CD4 + cell count, were independently associated with increased NAFLD risk. In all PWH with fatty liver, the frequency of liver stiffness measurement 8-12 kPa was 13.9% (95% CI 9%-20%) and ≥12 kPa 6.4% (95% CI 3%-11%), with a similar frequency of these liver stiffness measurement cutoffs in NAFLD. CONCLUSIONS Nearly half of the virally-suppressed PWH have FLD, 90% of which is due to NAFLD. A fifth of the PWH with FLD has clinically significant fibrosis, and 6% have advanced fibrosis. These data lend support to systematic screening for high-risk NAFLD in PWH.
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Affiliation(s)
- Samer Gawrieh
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Jordan E. Lake
- Division of Infectious Diseases, Department of Medicine, University of Texas Health Science Center at Houston, Houston, TX
| | - Paula Debroy
- Division of Infectious Diseases, Department of Medicine, University of Texas Health Science Center at Houston, Houston, TX
| | - Julia A. Sjoquist
- Liver Center, Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Montreca Robison
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Mark Tann
- Department of Radiology, Indiana University School of Medicine, Indianapolis, IN
| | - Fatih Akisik
- Department of Radiology, Indiana University School of Medicine, Indianapolis, IN
| | - Surya S. Bhamidipalli
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN
| | - Chandan K. Saha
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN
| | - Kimon Zachary
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Gregory K. Robbins
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Samir K. Gupta
- Division of Infectious Diseases, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Raymond T. Chung
- Liver Center, Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Naga Chalasani
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Kathleen E. Corey
- Liver Center, Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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Abiodun OE, Adebimpe O, Ndako JA, Oludoun O, Aladeitan B, Adeniyi M. Mathematical modeling of HIV-HCV co-infection model: Impact of parameters on reproduction number. F1000Res 2022; 11:1153. [PMID: 36636470 PMCID: PMC9817180 DOI: 10.12688/f1000research.124555.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2022] [Indexed: 09/19/2023] Open
Abstract
Background: Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) are both as classified blood-borne viruses since they are transmitted through contact with contaminated blood. Approximately 1.3 million of the 2.75 million global HIV/HCV carriers inject drugs (PWID). HIV co-infection has a harmful effect on the progression of HCV, resulting in greater rates of HCV persistence after acute infection, higher viral levels, and accelerated progression of liver fibrosis and end-stage liver disease. In this study, we developed and investigated a mathematical model for the dynamical behavior of HIV/AIDS and HCV co-infection, which includes therapy for both diseases, vertical transmission in HIV cases, unawareness and awareness of HIV infection, inefficient HIV treatment follow-up, and efficient condom use. Methods: Positivity and boundedness of the model under investigation were established using well-known theorems. The equilibria were demonstrated by bringing all differential equations to zero. The associative reproduction numbers for mono-infected and dual-infected models were calculated using the next-generation matrix approach. The local and global stabilities of the models were validated using the linearization and comparison theorem and the negative criterion techniques of bendixson and dulac, respectively. Results: The growing prevalence of HIV treatment dropout in each compartment of the HIV model led to a reduction in HIV on treatment compartments while other compartments exhibited an increase in populations . In dually infected patients, treating HCV first reduces co-infection reproduction number R ech , which reduces liver cancer risk. Conclusions: From the model's results, we infer various steps that policymakers could take to reduce the number of mono-infected and co-infected individuals.
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Affiliation(s)
| | - Olukayode Adebimpe
- Mathematics and Statistics, First Technical University, Ibadan, Oyo, Nigeria
| | - James A. Ndako
- Physical Sciences, Landmark University, Omu Aran, State, 251101, Nigeria
| | - Olajumoke Oludoun
- Physical Sciences, Landmark University, Omu Aran, State, 251101, Nigeria
| | | | - Michael Adeniyi
- Mathematics and Statistics, Lagos State Polytechnic, Lagos, Lagos, Nigeria
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Abiodun OE, Adebimpe O, Ndako JA, Oludoun O, Aladeitan B, Adeniyi M. Mathematical modeling of HIV-HCV co-infection model: Impact of parameters on reproduction number. F1000Res 2022; 11:1153. [PMID: 36636470 PMCID: PMC9817180 DOI: 10.12688/f1000research.124555.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Abstract
Background: Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) are both classified as blood-borne viruses since they are transmitted through contact with contaminated blood. Approximately 1.3 million of the 2.75 million global HIV/HCV carriers are people who inject drugs (PWID). HIV co-infection has a harmful effect on the progression of HCV, resulting in greater rates of HCV persistence after acute infection, higher viral levels, and accelerated progression of liver fibrosis and end-stage liver disease. In this study, we developed and investigated a mathematical model for the dynamical behavior of HIV/AIDS and HCV co-infection, which includes therapy for both diseases, vertical transmission in HIV cases, unawareness and awareness of HIV infection, inefficient HIV treatment follow-up, and efficient condom use. Methods: Positivity and boundedness of the model under investigation were established using well-known theorems. The equilibria were demonstrated by bringing all differential equations to zero. The associative reproduction numbers for mono-infected and dual-infected models were calculated using the next-generation matrix approach. The local and global stabilities of the models were validated using the linearization and comparison theorem and the negative criterion techniques of bendixson and dulac, respectively. Results: The growing prevalence of HIV treatment dropout in each compartment of the HIV model led to a reduction in HIV on treatment compartments while other compartments exhibited an increase in populations . In dually infected patients, treating HCV first reduces co-infection reproduction number R ech , which reduces liver cancer risk. Conclusions: From the model's results, we infer various steps (such as: campaigns to warn individuals about the consequences of having multiple sexual partners; distributing more condoms to individuals; continuing treatment for chronic HCV and AIDS) that policymakers could take to reduce the number of mono-infected and co-infected individuals.
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Affiliation(s)
| | - Olukayode Adebimpe
- Mathematics and Statistics, First Technical University, Ibadan, Oyo, Nigeria
| | - James A. Ndako
- Physical Sciences, Landmark University, Omu Aran, State, 251101, Nigeria
| | - Olajumoke Oludoun
- Physical Sciences, Landmark University, Omu Aran, State, 251101, Nigeria
| | | | - Michael Adeniyi
- Mathematics and Statistics, Lagos State Polytechnic, Lagos, Lagos, Nigeria
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5
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Khalili M, King WC, Kleiner DE, Chung RT, Bhan AK, Ghany MG, Sulkowski MS, Lisker-Melman M, Jain MK, Janssen HLA, Hinerman AS, Sanyal AJ, Sterling RK. Evolution of Fatty Liver Disease and Relationship With Lipoproteins and Clinical Outcomes in Hepatitis B/Human Immunodeficiency Virus Coinfection. Clin Infect Dis 2022; 74:1914-1924. [PMID: 34698347 PMCID: PMC9630874 DOI: 10.1093/cid/ciab764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Fatty liver disease (FLD) and hepatitis B virus (HBV) infection occur commonly in human immunodeficiency virus (HIV). FLD resolution is associated with improvement in lipoproteins in HIV-uninfected patients. We evaluated changes in FLD in an HBV/HIV-coinfected cohort. METHODS One hundred eight HBV/HIV-coinfected adults with baseline liver biopsies were followed every 24 weeks (median, 166 weeks) and 60 had follow-up biopsies. Baseline FLD categories (none, ≥5% steatosis, steatohepatitis), their change, and relationships with clinical and lipid/lipoprotein parameters were explored using multivariable modeling. RESULTS Median age was 50 years, and 93% were male. At baseline 30% had FLD. With control for lipid-lowering medications and body mass index, low-density lipoprotein (LDL) cholesterol (LDL-C), LDL particle concentration (LDL-P), and apolipoprotein B (apoB) decreased and adiponectin increased over time (all P < .05); On follow-up (vs baseline), there was no significant difference in FLD category (P = .85); 60% remained without FLD, 17% had unchanged, 12% worsening, and 12% improved FLD. Baseline low-density lipoproteins (LDL-C, LDL-P, small LDL-P) and apoB appeared highest in those with unchanged FLD status (all P < .05). No associations between changes in FLD across follow-up (worsening/improvement vs unchanged) and lipid/lipoproteins changes were identified. CONCLUSIONS In this cohort, there was no significant change in FLD prevalence over a relatively short timeframe. Baseline atherogenic lipids appeared highest in those with persistent steatosis or steatohepatitis, suggesting potentially increased cardiovascular risk in this group, but an independent relationship between individual-level change in FLD status and lipid/lipoprotein levels across follow-up was not observed.
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Affiliation(s)
- Mandana Khalili
- University of California, San Francisco, San Francisco, California, USA
| | - Wendy C King
- University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | | | - Raymond T Chung
- Massachusetts General Hospital, Boston, Massachusetts,USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Atul K Bhan
- Massachusetts General Hospital, Boston, Massachusetts,USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Marc G Ghany
- National Institutes of Health, Bethesda, Maryland, USA
| | | | - Mauricio Lisker-Melman
- Washington University School of Medicine and John Cochran Veterans Affairs Medical Center, St Louis, USA
| | - Mamta K Jain
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | - Amanda S Hinerman
- University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Arun J Sanyal
- Virginia Commonwealth University, Richmond, Virginia, USA
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6
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Kenfack-Momo R, Kenmoe S, Takuissu GR, Ebogo-Belobo JT, Kengne-Ndé C, Mbaga DS, Tchatchouang S, Oyono MG, Kenfack-Zanguim J, Lontuo Fogang R, Mbongue Mikangue CA, Zeuko'o Menkem E, Ndzie Ondigui JL, Kame-Ngasse GI, Magoudjou-Pekam JN, Taya-Fokou JB, Bowo-Ngandji A, Nkie Esemu S, Kamdem Thiomo D, Moundipa Fewou P, Ndip L, Njouom R. Epidemiology of hepatitis B virus and/or hepatitis C virus infections among people living with human immunodeficiency virus in Africa: A systematic review and meta-analysis. PLoS One 2022; 17:e0269250. [PMID: 35639675 PMCID: PMC9154112 DOI: 10.1371/journal.pone.0269250] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 05/17/2022] [Indexed: 02/07/2023] Open
Abstract
Introduction Due to their common routes of transmission, human immunodeficiency virus (HIV) coinfection with hepatitis B virus (HBV) and/or hepatitis C virus (HCV) has become a major public health problem worldwide, particularly in Africa, where these viruses are endemic. Few systematic reviews report the epidemiological data of HBV and/or HCV coinfection with HIV in Africa, and none provided data on the case fatality rate (CFR) associated with this coinfection. This study was conducted to investigate the prevalence and case fatality rate of HBV and/or HCV infections among people living with human immunodeficiency virus (PLHIV) in Africa. Methods We conducted a systematic review of published articles in PubMed, Web of Science, African Journal Online, and African Index Medicus up to January 2022. Manual searches of references from retrieved articles and grey literature were also performed. The meta-analysis was performed using a random-effects model. Sources of heterogeneity were investigated using subgroup analysis, while funnel plots and Egger tests were performed to assess publication bias. Results Of the 4388 articles retrieved from the databases, 314 studies met all the inclusion criteria. The overall HBV case fatality rate estimate was 4.4% (95% CI; 0.7–10.3). The overall seroprevalences of HBV infection, HCV infection, and HBV/HCV coinfection in PLHIV were 10.5% [95% CI = 9.6–11.3], 5.4% [95% CI = 4.6–6.2], and 0.7% [95% CI = 0.3–1.0], respectively. The pooled seroprevalences of current HBsAg, current HBeAg, and acute HBV infection among PLHIV were 10.7% [95% CI = 9.8–11.6], 7.0% [95% CI = 4.7–9.7], and 3.6% [95% CI = 0.0–11.0], respectively. Based on HBV-DNA and HCV-RNA detection, the seroprevalences of HBV and HCV infection in PLHIV were 17.1% [95% CI = 11.5–23.7] and 2.5% [95% CI = 0.9–4.6], respectively. Subgroup analysis showed substantial heterogeneity. Conclusions In Africa, the prevalence of hepatotropic viruses, particularly HBV and HCV, is high in PLHIV, which increases the case fatality rate. African public health programs should emphasize the need to apply and comply with WHO guidelines on viral hepatitis screening and treatment in HIV-coinfected patients. Review registration PROSPERO, CRD42021237795.
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Affiliation(s)
- Raoul Kenfack-Momo
- Department of Biochemistry, The University of Yaounde I, Yaounde, Cameroon
| | - Sebastien Kenmoe
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.,Virology Department, Centre Pasteur of Cameroon, Yaoundé, Cameroon
| | - Guy Roussel Takuissu
- Centre for Research on Health and Priority Pathologies, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | - Jean Thierry Ebogo-Belobo
- Centre for Research on Health and Priority Pathologies, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | - Cyprien Kengne-Ndé
- Epidemiological Surveillance, Evaluation and Research Unit, National AIDS Control Committee, Douala, Cameroon
| | | | | | - Martin Gael Oyono
- Centre for Research on Health and Priority Pathologies, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | | | | | | | | | | | - Ginette Irma Kame-Ngasse
- Centre for Research on Health and Priority Pathologies, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | | | | | - Arnol Bowo-Ngandji
- Department of Microbiology, The University of Yaounde I, Yaounde, Cameroon
| | | | | | | | - Lucy Ndip
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Richard Njouom
- Virology Department, Centre Pasteur of Cameroon, Yaoundé, Cameroon
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7
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Liu S, Zhou Y, Wang Y, Li CB, Wang W, Lu X, Liu P, Hu QH, Wen Y. The Correlated Risk Factors for Severe Liver Damage Among HIV-Positive Inpatients With Abnormal Liver Tests. Front Med (Lausanne) 2022; 9:817370. [PMID: 35273978 PMCID: PMC8901992 DOI: 10.3389/fmed.2022.817370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 01/31/2022] [Indexed: 12/04/2022] Open
Abstract
Background: This study investigated the factors correlated with severe liver damage among HIV-infected inpatients. Methods: We retrospectively collected the first hospitalized HIV-infected patients in the Department of Infectious Disease of the First Affiliated Hospital of China Medical University from January 1, 2010, to December 31, 2019. We used multivariate logistic regression to identify the factors associated with severe liver damage. Results: A total of 493 patients with abnormal liver tests were recruited. Among 63 cases (12.8%) with severe liver injury, drug-induced liver injury (DILI) identified by the updated Roussel Uclaf Causality Assessment Method (RUCAM) score as the direct cause was found in 43 cases. Anti-tuberculosis drug (ATD) exposure [adjusted odds ratio (aOR) = 1.835, 95% confidence interval (CI): 1.031–3.268], cotrimoxazole exposure (aOR = 2.775, 95% CI: 1.511–5.096), comorbidity of viral hepatitis (aOR = 2.340, 95% CI: 1.161–4.716), alcohol consumption history (aOR = 2.392, 95% CI: 1.199–4.769), and thrombocytopenia (aOR = 2.583, 95% CI:1.127–5.917) were associated with severe liver injury (all P < 0.05). Conclusions: DILI was the predominant cause of severe liver damage, followed by hepatitis virus co-infection. For patients with alcohol consumption and thrombocytopenia, frequent monitoring of liver function tests should be considered.
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Affiliation(s)
- Sheng Liu
- Infectious Diseases Department, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Ying Zhou
- Infectious Diseases Department, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yu Wang
- Infectious Diseases Department, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Cheng Bo Li
- Infectious Diseases Department, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Wen Wang
- Infectious Diseases Department, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xu Lu
- Infectious Diseases Department, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Pei Liu
- Infectious Diseases Department, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Qing Hai Hu
- Key Laboratory of AIDS Immunology of Ministry of Health, Department of Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Ying Wen
- Infectious Diseases Department, The First Affiliated Hospital of China Medical University, Shenyang, China
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Wang X, Yu Y, Wang P, Yang K, Wang Y, Yan L, Zhong XB, Zhang L. Long Noncoding RNAs Hepatocyte Nuclear Factor 4A Antisense RNA 1 and Hepatocyte Nuclear Factor 1A Antisense RNA 1 are Involved in Ritonavir-induced Cytotoxicity in Hepatoma Cells. Drug Metab Dispos 2021; 50:704-715. [PMID: 34949673 PMCID: PMC9132102 DOI: 10.1124/dmd.121.000693] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 12/16/2021] [Indexed: 11/22/2022] Open
Abstract
Ritonavir (RTV), a pharmacoenhancer used in anti-HIV regimens, can induce liver damage. RTV is primarily metabolized by cytochrome P450 3A4 (CYP3A4) in the liver. HNF4A antisense RNA 1 (HNF4A-AS1) and HNF1A antisense RNA 1 (HNF1A-AS1) are long noncoding RNAs (lncRNAs) that regulate the expression of pregnane X receptor (PXR) and CYP3A4. This study investigated the role and underlying mechanisms of HNF4A-AS1 and HNF1A-AS1 in RTV-induced hepatotoxicity. HNF4A-AS1 and HNF1A-AS1 were knocked down by small hairpin RNAs in Huh7 and HepG2 cells. Lactate dehydrogenase and reactive oxygen species assays were performed to assess RTV-induced hepatotoxicity. Chromatin immunoprecipitation qPCR was used to detect PXR enrichment and histone modifications in the CYP3A4 promoter. HNF4A-AS1 knockdown increased PXR and CYP3A4 expression and exacerbated RTV-induced cytotoxicity, whereas HNF1A-AS1 knockdown generated the opposite phenotype. Mechanistically, enrichment of PXR and trimethylation of histone 3 lysine 4 (H3K4me3) in the CYP3A4 promoter was increased, and trimethylation of histone 3 lysine 27 (H3K27me3) was decreased after HNF4A-AS1 knockdown. However, PXR and H3K4me3 enrichment decreased after HNF1A-AS1 knockdown. Alterations in RTV-induced hepatotoxicity caused by decreasing HNF4A-AS1 or HNF1A-AS1 were reversed by knockdown or overexpression of PXR. Increased susceptibility to RTV-induced liver injury caused by the PXR activator rifampicin was attenuated by HNF4A-AS1 overexpression or HNF1A-AS1 knockdown. Taken together, these results revealed that HNF4A-AS1 and HNF1A-AS1 modulated RTV-induced hepatotoxicity by regulating CYP3A4 expression, primarily by affecting the binding of PXR and histone modification status in the CYP3A4 promoter. Significance Statement HNF4A-AS1 and HNF1A-AS1, transcribed separately from neighboring antisense genes of the human transcription factor genes HNF4A and HNF1A, were identified as lncRNAs that can affect RTV-induced hepatotoxicity and susceptibility to RTV-induced hepatotoxicity caused by rifampicin exposure, mainly by affecting the expression of CY3A4 via alterations in PXR enrichment and histone modification status in the CYP3A4 promoter. This discovery provides directions for further research on the mechanisms of RTV-induced liver injury.
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Affiliation(s)
- Xiaofei Wang
- School of Basic Medical Sciences, Zhengzhou University, China
| | - Yihang Yu
- School of Basic Medical Sciences, Zhengzhou University, China
| | | | - Kun Yang
- School of Basic Medical Sciences, Zhengzhou University, China
| | - Yiting Wang
- School of Basic Medical Sciences, Zhengzhou University, China
| | - Liang Yan
- The First Affiliated Hospital of Zhengzhou University, China
| | - Xiao-Bo Zhong
- Pharmaceutical Sciences, University of Connecticut, United States
| | - Lirong Zhang
- Department of Pharmacology, School of Basic Medical Sciences, Zhengzhou University, China
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Khalili M, King WC, Kleiner DE, Jain MK, Chung RT, Sulkowski M, Lisker-Melman M, Wong DK, Ghany M, Sanyal A, Sterling RK. Fatty Liver Disease in a Prospective North American Cohort of Adults With Human Immunodeficiency Virus and Hepatitis B Virus Coinfection. Clin Infect Dis 2021; 73:e3275-e3285. [PMID: 32869840 PMCID: PMC8563226 DOI: 10.1093/cid/ciaa1303] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) and fatty liver disease (FLD) are common in human immunodeficiency virus (HIV). Correlates of FLD and its relationship with alanine aminotransferase (ALT) were examined longitudinally in HIV-HBV coinfection. METHODS From 28/4/2014-7/11/2018, 114 HIV-HBV adults had liver biopsy and were followed for a median of 3 years (ancillary study of Hepatitis B Research Network). Steatohepatitis was based on presence of steatosis, ballooning, and perisinusoidal fibrosis. FLD was defined as ≥5% steatosis and/or steatohepatitis. RESULTS Median age was 49 years, 93% were male, 51% black, 93% had HIV RNA <400 copies/mL and 83% HBV DNA <1000 IU/mL. Thirty percent had FLD (20% steatosis, 10% steatohepatitis). Those with FLD had higher median triglyceride (171 vs 100 mg/dL, P < .01) and small, dense LDL (44 vs 29 mg/dL, P < .01) and lower HDL-2-C (9 vs 12 mg/dL, P = .001). After adjusting for age, sex, and alcohol use, white and other versus black race (ORs, 8.49 and 16.54, respectively), ALT (OR, 3.13/doubling), hypertension (OR, 10.93), hyperlipidemia (OR, 4.36), and diabetes family history (OR, 5.38) were associated with having FLD (all P < .05). Steatohepatitis or steatosis alone (vs none) was associated with higher ALT over time (1.93 and 1.34 times higher, respectively; P < .001), with adjustment for age, sex, and HBV DNA. CONCLUSIONS About 30% with HIV-HBV coinfection had FLD including 10% with steatohepatitis. FLD was associated with non-black race, metabolic risks, an atherogenic lipid profile, and elevated ALT over time. Thus, identification of FLD and management of adverse metabolic profiles are critically important in HIV-HBV coinfection. Clinical Trial Registration. NCT01924455.
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Affiliation(s)
- Mandana Khalili
- University of California San Francisco, San Francisco, California, USA
| | - Wendy C King
- University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | | | - Mamta K Jain
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | | | | | | | - Marc Ghany
- National Institutes of Health, Bethesda, Maryland, USA
| | - Arun Sanyal
- Virginia Commonwealth University, Richmond, Virginia, USA
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10
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Lin H, Fan Y, Wieser A, Zhang J, Regel I, Nieß H, Mayerle J, Gerbes AL, Steib CJ. Albumin Might Attenuate Bacteria-Induced Damage on Kupffer Cells for Patients with Chronic Liver Disease. Cells 2021; 10:cells10092298. [PMID: 34571946 PMCID: PMC8469739 DOI: 10.3390/cells10092298] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/20/2021] [Accepted: 09/01/2021] [Indexed: 12/29/2022] Open
Abstract
Chronic liver diseases (CLDs) are complex diseases that cause long-term inflammation and infection, which in turn accelerate their development. The usage of albumin in patients with CLDs has been debated for years. Human serum albumin (HSA) plays a key role in immunomodulation during the process of CLDs. The correlation between albumin and C-reactive protein (CRP) in CLD patients was analyzed by linear regression with the Pearson statistic. The damage of THP-1 and primary cells was evaluated by measuring the lactate dehydrogenase (LDH) in the supernatant. Immunofluorescence staining was performed to determine underlying pathways in Kupffer cells (KCs). Albumin negatively correlated with infection in patients with CLDs. In vitro experiments with THP-1 cells and KCs showed that albumin reduced LDH release after stimulation with bacterial products, while no differences in hepatic stellate cells (HSCs) and sinusoidal endothelial cells (SECs) were detected. Moreover, immunofluorescence staining revealed an increase of p-ERK and p-NF-kB p65 density after albumin treatment of KCs stimulated by bacterial products. In conclusion, albumin could assist CLD patients in alleviating inflammation caused by bacterial products and might be beneficial to patients with CLDs by securing KCs from bacteria-induced damage, providing a compelling rationale for albumin therapy in patients with CLDs.
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Affiliation(s)
- Hao Lin
- Liver Center Munich, Department of Medicine II, University Hospital, 81377 Munich, Germany; (H.L.); (Y.F.); (I.R.); (J.M.); (A.L.G.)
| | - Yuhui Fan
- Liver Center Munich, Department of Medicine II, University Hospital, 81377 Munich, Germany; (H.L.); (Y.F.); (I.R.); (J.M.); (A.L.G.)
| | - Andreas Wieser
- Max von Pettenkofer Institute, Faculty of Medicine, Medical Microbiology and Hospital Epidemiology, 80336 Munich, Germany;
- Division of Infectious Diseases and Tropical Medicine, University Hospital, 80802 Munich, Germany
- German Center for Infection Research (DZIF), Partner Site Munich, 80802 Munich, Germany
| | - Jiang Zhang
- Liver Transplantation Center, Department of Liver Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China;
| | - Ivonne Regel
- Liver Center Munich, Department of Medicine II, University Hospital, 81377 Munich, Germany; (H.L.); (Y.F.); (I.R.); (J.M.); (A.L.G.)
| | - Hanno Nieß
- Biobank of the Department of General, Visceral and Transplant Surgery, University Hospital, 80802 Munich, Germany;
| | - Julia Mayerle
- Liver Center Munich, Department of Medicine II, University Hospital, 81377 Munich, Germany; (H.L.); (Y.F.); (I.R.); (J.M.); (A.L.G.)
| | - Alexander L. Gerbes
- Liver Center Munich, Department of Medicine II, University Hospital, 81377 Munich, Germany; (H.L.); (Y.F.); (I.R.); (J.M.); (A.L.G.)
| | - Christian J. Steib
- Liver Center Munich, Department of Medicine II, University Hospital, 81377 Munich, Germany; (H.L.); (Y.F.); (I.R.); (J.M.); (A.L.G.)
- Correspondence: ; Tel.: +49-89-4400-72298; Fax: +49-89-4400-75299
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11
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Wood S, Won SH, Hsieh HC, Lalani T, Kronmann K, Maves RC, Utz G, Schofield C, Colombo RE, Okulicz JF, Blaylock J, Agan BK, Ganesan A. Risk Factors Associated With Chronic Liver Enzyme Elevation in Persons With HIV Without Hepatitis B or C Coinfection in the Combination Antiretroviral Therapy Era. Open Forum Infect Dis 2021; 8:ofab076. [PMID: 33738323 PMCID: PMC7953661 DOI: 10.1093/ofid/ofab076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 02/19/2021] [Indexed: 02/06/2023] Open
Abstract
Background As morbidity due to viral coinfections declines among HIV-infected persons, changes in liver-related morbidity are anticipated. We examined data from the US Military HIV Natural History Study (NHS), a cohort of military beneficiaries, to evaluate incidence and risk factors associated with chronic liver enzyme elevation (cLEE) in HIV-monoinfected patients in the combination antiretroviral therapy (cART) era. Methods Participants who were hepatitis B virus and hepatitis C virus seronegative with follow-up after 1996 were included. We defined chronic liver enzyme elevation (cLEE) as alanine aminotransferase elevations ≥1.25 times the upper limit of normal on at least 2 visits, for a duration of ≥6 months within 2 years. We used multivariate Cox proportional hazards models to examine risk factors for cLEE. Results Of 2779 participants, 309 (11%) met criteria for cLEE for an incidence of 1.28/100 PYFU (1.28–1.29/100 PYFU). In an adjusted model, cLEE was associated with Hispanic/other ethnicity (reference Caucasian: hazard ratio [HR], 1.744; 95% CI, 1.270–2.395), non–nucleoside reverse transcriptase inhibitor–based cART (reference boosted protease inhibitors: HR, 2.232; 95% CI, 1.378–3.616), being cART naïve (HR, 6.046; 95% CI, 3.686–9.915), or having cART interruptions (HR, 8.671; 95% CI, 4.651–16.164). African American race (HR, 0.669; 95% CI, 0.510–0.877) and integrase strand transfer inhibitor (INSTI)–based cART (HR, 0.222; 95% CI, 0.104–0.474) were protective. Conclusions Our findings demonstrate that initiation and continued use of cART are protective against cLEE and support the hypothesis that HIV infection directly impacts the liver. INSTI-based regimens were protective and could be considered in persons with cLEE.
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Affiliation(s)
- Shannon Wood
- Department of Internal Medicine, Madigan Army Medical Center, Tacoma, Washington, USA.,Division of Infectious Diseases, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.,Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,Division of Infectious Diseases, Madigan Army Medical Center, Tacoma, Washington, USA
| | - Seung Hyun Won
- Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Hsing-Chuan Hsieh
- Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Tahaniyat Lalani
- Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA.,Division of Infectious Diseases, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
| | - Karl Kronmann
- Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,Division of Infectious Diseases, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
| | - Ryan C Maves
- Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,Division of Infectious Diseases, Naval Medical Center San Diego, San Diego, California, USA
| | - Gregory Utz
- Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,Division of Infectious Diseases, Naval Medical Center San Diego, San Diego, California, USA
| | - Christina Schofield
- Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,Division of Infectious Diseases, Madigan Army Medical Center, Tacoma, Washington, USA
| | - Rhonda E Colombo
- Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA.,Division of Infectious Diseases, Madigan Army Medical Center, Tacoma, Washington, USA
| | - Jason F Okulicz
- Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,Infectious Disease Service, San Antonio Military Medical Center, San Antonio, Texas, USA
| | - Jason Blaylock
- Division of Infectious Diseases, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.,Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Brian K Agan
- Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Anuradha Ganesan
- Division of Infectious Diseases, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.,Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
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12
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Wekesa C, Kirk GD, Aizire J, Benson EM, Karabarinde A, Parkes-Ratanshi R, Ocama P. Prevalence and Factors Associated With Liver Fibrosis Among Adult HIV-Infected Patients Attending Urban and Rural Care Clinics in Uganda. Open Forum Infect Dis 2020; 7:ofaa483. [PMID: 33241065 PMCID: PMC7676506 DOI: 10.1093/ofid/ofaa483] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 10/07/2020] [Indexed: 12/25/2022] Open
Abstract
Background Liver fibrosis is common among HIV-infected patients. Risk factors vary by location. Understanding this variation may inform prevention strategies. We compared the prevalence and correlates of liver fibrosis among HIV-infected patients attending care clinics in Uganda. Methods This was a cross-sectional study involving 2030 HIV-infected patients attending care clinics in urban and rural Uganda. Liver fibrosis was defined as liver stiffness measurement (LSM) >7.1 KPa. Proportions and correlates of liver fibrosis were assessed and compared using logistic regression stratified by gender and site. Results Prevalence of liver fibrosis was higher among participants in the rural clinic (15% vs 11%; P = .017). History of tobacco use (urban P = .022; rural P = .035) and serologic evidence of hepatitis C infection (HCV; urban P = .028; rural P = .03) was associated with liver fibrosis in all men. Elevated liver transaminases (urban P = .002; rural P = .028) and increasing age (urban P = .008; rural P = .052) were risk factors among all women. Tobacco use among women was only a risk factor in those attending the rural clinic (P = .003), and detectable HIV viral load (P = .002) for men in the urban clinic. Conclusions Liver fibrosis is prevalent among HIV-infected persons in Uganda. HIV viral suppression and avoiding tobacco may be strategies to prevent liver fibrosis and cancer risk.
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Affiliation(s)
- Clara Wekesa
- MRC/UVRI and London School of Hygiene and Tropical Medicine Uganda Research, Entebbe, Uganda.,HIV and HCC in Uganda (H2U) Consortium, Infectious Diseases Institute, Kampala, Uganda
| | - Gregory D Kirk
- John Hopkins University, Baltimore, Maryland, USA.,HIV and HCC in Uganda (H2U) Consortium, Infectious Diseases Institute, Kampala, Uganda
| | - Jim Aizire
- John Hopkins University, Baltimore, Maryland, USA.,HIV and HCC in Uganda (H2U) Consortium, Infectious Diseases Institute, Kampala, Uganda
| | - Eve-Marie Benson
- John Hopkins University, Baltimore, Maryland, USA.,HIV and HCC in Uganda (H2U) Consortium, Infectious Diseases Institute, Kampala, Uganda
| | - Alex Karabarinde
- MRC/UVRI and London School of Hygiene and Tropical Medicine Uganda Research, Entebbe, Uganda
| | | | - Ponsiano Ocama
- HIV and HCC in Uganda (H2U) Consortium, Infectious Diseases Institute, Kampala, Uganda.,Makerere University, College of Health Sciences, Kampala, Uganda
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13
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Pretreatment with zinc protects Kupffer cells following administration of microbial products. Biomed Pharmacother 2020; 127:110208. [PMID: 32417689 DOI: 10.1016/j.biopha.2020.110208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 04/26/2020] [Accepted: 04/28/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Systemic inflammation and severe fibrosis can reduce serum zinc levels, while zinc supplementation is reported to improve the prognosis of patients with chronic liver disease (CLD). OBJECTIVES We aimed to investigate the clinical application of serum zinc in patients with CLD and the anti-infective mechanism of zinc supplementation. METHODS Based on the serum zinc level, 149 CLD patients were divided into 3 groups and their clinical parameters were compared. In in-vitro experiments, microbial isolates derived from patients were used to stimulate human liver non-parenchymal cells, and the zinc sulfate solution was added in certain experiments. The effect of zinc was compared by LDH and thromboxane A2 levels in the cell supernatant. RESULT Compared with other groups, patients with low serum zinc levels had significantly higher C-reactive protein (CRP), total bilirubin, INR, creatinine, and MELD scores, while albumin and GOT levels were reduced. Only CRP and albumin were significantly correlated with serum zinc in both low and normal-zinc groups. Bacterial isolates significantly increased LDH levels in Kupffer cells (KCs) and stellate cells but had no effect on sinusoidal endothelial cells, whereas zinc pretreatment protected KCs but not stellate cells. Thromboxane A2 secreted by KCs can also be induced by bacterial stimulation, accompanied by increased gene expression of Myd88, MAPK and NF-kB, while zinc pretreatment can attenuate that. CONCLUSION Serum zinc levels can be used to estimate infection and liver fibrosis in CLD patients. As a new antibacterial weapon, zinc supplementation acts on KCs through Myd88-MAPK related pathways.
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14
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Khalatbari A, Mishra P, Han H, He Y, MacVeigh-Aloni M, Ji C. Ritonavir and Lopinavir Suppress RCE1 and CAAX Rab Proteins Sensitizing the Liver to Organelle Stress and Injury. Hepatol Commun 2020; 4:932-944. [PMID: 32490327 PMCID: PMC7262282 DOI: 10.1002/hep4.1515] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 03/02/2020] [Accepted: 03/15/2020] [Indexed: 02/06/2023] Open
Abstract
Organelle stress and Liver injuries often occur in human immunodeficiency virus (HIV) infected patients under anti-HIV therapies, yet few molecular off-targets of anti-HIV drugs have been identified in the liver. Here, we found through total RNA sequencing that the transcription of a host protease Ras converting CAAX endopeptidase 1 (RCE1) was altered in HepG2 cells treated with anti-HIV protease inhibitors, ritonavir and lopinavir. Levels of RCE1 protein were inhibited in HepG2 and primary mouse hepatocytes and in the liver of mice treated with the anti-HIV drugs, which were accompanied with inhibition of two potential substrates of RCE1, small GTP binding protein Rab13 and Rab18, which are with a common CAAX motif and known to regulate the ER-Golgi traffic or lipogenesis. Neither Rce1 transcription nor RCE1 protein level was inhibited by Brefeldin A, which is known to interfere with the ER-Golgi traffic causing Golgi stress. Knocking down Rce1 with RNA interference increased ritonavir and lopinavir-induced cell death as well as expression of Golgi stress response markers, TFE3, HSP47 and GCP60, in both primary mouse hepatocytes and mouse liver, and deteriorated alcohol-induced alanine aminotransferase (ALT) and fatty liver injury in mice. In addition, overexpressing Rab13 or Rab18 in primary human hepatocytes reduced partially the anti-HIV drugs and alcohol-induced Golgi fragmentation, Golgi stress response, and cell death injury. Conclusion: We identified a mechanism linking a host protease and its substrates, small guanosine triphosphate-binding proteins, to the anti-HIV drug-induced Golgi dysfunction, organelle stress response, and fatty liver injury.
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Affiliation(s)
- Atousa Khalatbari
- Department of Medicine Keck School of Medicine of USC University of Southern California Los Angeles CA
| | - Pratibha Mishra
- Department of Medicine Keck School of Medicine of USC University of Southern California Los Angeles CA
| | - Hui Han
- Department of Medicine Keck School of Medicine of USC University of Southern California Los Angeles CA
| | - Yuxin He
- Department of Medicine Keck School of Medicine of USC University of Southern California Los Angeles CA
| | - Michelle MacVeigh-Aloni
- Department of Medicine Keck School of Medicine of USC University of Southern California Los Angeles CA
| | - Cheng Ji
- Department of Medicine Keck School of Medicine of USC University of Southern California Los Angeles CA
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15
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Ji C. Dissecting the Role of Disturbed ER-Golgi Trafficking in Antivirals and Alcohol Abuse-Induced Pathogenesis of Liver Disorders. ACTA ACUST UNITED AC 2017; 3. [PMID: 29399658 PMCID: PMC5791917 DOI: 10.21767/2471-853x.100054] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Antiviral drugs and alcohol abuse-induced organelle stresses have been linked to many disorders and the underlying molecular mechanisms are under intense investigations. This brief review communicates emerging evidence and research trends on how certain antivirals and alcohol affect ER-Golgi trafficking, which potentially impacts the function and integrity of the Golgi apparatus contributing to endoplasmic reticulum stress and cellular injury.
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Affiliation(s)
- Cheng Ji
- Department of Medicine, Keck School of Medicine of USC, Los Angeles, CA, USA
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16
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Lazarus JV, Laut KG, Safreed-Harmon K, Peters L, Johnson M, Fätkenheuer G, Khromova I, Vandekerckhove L, Maciejewska K, Radoi R, Ridolfo AL, Mocroft A. Disparities in HIV clinic care across Europe: findings from the EuroSIDA clinic survey. BMC Infect Dis 2016; 16:335. [PMID: 27439376 PMCID: PMC4955207 DOI: 10.1186/s12879-016-1685-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 06/16/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although advances in HIV medicine have yielded increasingly better treatment outcomes in recent years, HIV-positive people with access to antiretroviral therapy (ART) still face complex health challenges. The EuroSIDA Study Group surveyed its clinics to explore regional differences in clinic services. METHODS The EuroSIDA study is a prospective observational cohort study that began enrolling patients in 1994. In early 2014, we conducted a 59-item survey of the 98 then-active EuroSIDA clinics. The survey covered HIV clinical care and other aspects of patient care. The EuroSIDA East Europe study region (Belarus, Estonia, Lithuania, the Russian Federation and Ukraine) was compared to a "non-East Europe" study region comprised of all other EuroSIDA countries. RESULTS A larger proportion of clinics in the East Europe group reported deferring ART in asymptomatic patients until the CD4 cell count dropped below 350 cells/mm(3) (75 % versus 25 %, p = 0.0032). Considerably smaller proportions of East Europe clinics reported that resistance testing was provided before ART initiation (17 % versus 86 %, p < 0.0001) and that it was provided upon treatment failure (58 % versus 90 %, p = 0.0040). Only 33 % of East Europe clinics reported providing hepatitis B vaccination, compared to 88 % of other clinics (p < 0.0001). Only 50 % of East Europe clinics reported having access to direct-acting antivirals for hepatitis C treatment, compared to 89 % of other clinics (p = 0.0036). There was significantly less tuberculosis/HIV treatment integration in the East Europe group (27 % versus 84 % p < 0.0001) as well as significantly less screening for cardiovascular disease (58 % versus 90 %, p = 0.014); tobacco use (50 % versus 93 %, p < 0.0001); alcohol consumption (50 % versus 93 %, p < 0.0001); and drug use (58 % versus 87 %, p = 0.029). CONCLUSIONS Study findings demonstrate how specific features of HIV clinics differ across Europe. Significantly more East Europe clinics deferred ART in asymptomatic patients for longer, and significantly fewer East Europe clinics provided resistance testing before initiating ART or upon ART failure. The East Europe group of clinics also differed in regard to hepatitis B vaccination, direct-acting antiviral access, tuberculosis/HIV treatment integration and screening for other health issues. There is a need for further research to guide setting-specific decision-making regarding the optimal array of services at HIV clinics in Europe and worldwide.
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Affiliation(s)
- Jeffrey V Lazarus
- CHIP - Centre for Health and Infectious Disease Research, Rigshospitalet, University of Copenhagen, Øster Alle 56, 5. sal, DK-2100, Copenhagen, Denmark.
| | - Kamilla Grønborg Laut
- CHIP - Centre for Health and Infectious Disease Research, Rigshospitalet, University of Copenhagen, Øster Alle 56, 5. sal, DK-2100, Copenhagen, Denmark
| | - Kelly Safreed-Harmon
- CHIP - Centre for Health and Infectious Disease Research, Rigshospitalet, University of Copenhagen, Øster Alle 56, 5. sal, DK-2100, Copenhagen, Denmark
| | - Lars Peters
- CHIP - Centre for Health and Infectious Disease Research, Rigshospitalet, University of Copenhagen, Øster Alle 56, 5. sal, DK-2100, Copenhagen, Denmark
| | - Margaret Johnson
- Royal Free and University College Medical School, London, United Kingdom
| | | | - Irina Khromova
- Centre for HIV/AIDS and infectious diseases, Kaliningrad, Russian Federation
| | - Linos Vandekerckhove
- HIV Translational Research Unit (HTRU), Department of Internal Medicine, Ghent University and Ghent University Hospital, Ghent, Belgium
| | - Katarzyna Maciejewska
- Department of Infectious, Tropical Diseases and Aquired Immunodeficiencies of Pomeranian Medical University, Szczecin, Poland
| | | | | | - Amanda Mocroft
- Department of Infection and Population Health, University College London, London, United Kingdom
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17
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Liver involvement in human immunodeficiency virus infection. Indian J Gastroenterol 2016; 35:260-73. [PMID: 27256434 DOI: 10.1007/s12664-016-0666-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 05/01/2016] [Indexed: 02/04/2023]
Abstract
The advances in management of patients with acquired immunodeficiency syndrome (AIDS) with highly effective anti-retroviral therapy (HAART) have resulted in increased longevity of patients with human immunodeficiency virus (HIV) infection. AIDS-related illnesses now account for less than 50 % of the deaths, and liver diseases have emerged as the leading cause of death in patients with HIV infection. Chronic viral hepatitis, drug-related hepatotoxicity, non-alcoholic fatty liver disease, and opportunistic infections are the common liver diseases that are seen in HIV-infected individuals. Because of the shared routes of transmission, co-infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) are very common in HIV-infected persons. Hepatitis C is the most common viral hepatitis seen in HIV-infected patients. With the availability of directly acting agents, treatment outcome of HCV is comparable to that seen in non HIV-infected patients. Careful monitoring is required for drug interactions and drug-induced hepatotoxicity and modification of drugs should be done where necessary. The results of liver transplantation in select HIV-infected patients can be comparable with those of HIV-negative patients.
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18
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Epidemiology of sexually transmitted viral hepatitis in human immunodeficiency virus-positive men who have sex with men in Asia. J Formos Med Assoc 2015; 114:1154-61. [PMID: 26375778 DOI: 10.1016/j.jfma.2015.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 07/02/2015] [Accepted: 08/11/2015] [Indexed: 01/10/2023] Open
Abstract
Both human immunodeficiency virus (HIV) and viral hepatitis constitute major disease burden globally. As with other parts of the world, the HIV epidemic in Asia impacts mainly on men who have sex with men, one of the at-risk populations for sexually transmitted viral hepatitis. With the increasing availability of effective antiretroviral therapy, HIV-related mortality of people living with HIV has markedly reduced. Liver disease has become an important cause of mortality and morbidity in the HIV-infected population. With the improvement of socioeconomic conditions and availability of healthcare in Asian countries in recent years, the epidemiology of sexually transmitted viral hepatitis among HIV-positive men who have sex with men has also evolved. This review updates the epidemiology of different types of sexually transmitted viral hepatitis in this defined population in Asia.
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