Title : Microbial translocation is associated with advanced liver fibrosis among people living with HIV in Southwest China
Abstract:
Background: The prevalence of liver complications is increasing among people living with HIV (PLWH) where microbial translocation (MT) might play a vital role. We conducted a prospective cohort study aiming to evaluate association between plasma biomarkers of MT and liver fibrosis (LF) among PLWH in Southwest China.
Method: A total of 665 PLWH were enrolled at baseline and had at least one follow-up visit during a three-year study period. Liver fibrosis index (FIB-4) was calculated for LF evaluation. Plasma soluble CD14 (sCD14) and lipopolysaccharide binding protein (LBP) were measured as surrogate biomarkers for MT. Ordinal logistic regression was performed to investigate correlates of LF at baseline, and a linear mixed model was employed to examine the association between dynamic changes of MT biomarkers and LF.
Results: Of the participants, 61 (9.17%) had advanced LF (FIB-4 >3.25) while 193 (29.02%) had moderate LF (1.45≤FIB-4≤3.25). Patients with advanced LF had higher plasma levels of sCD14 and LBP than those with moderate or without LF both at baseline and follow-up. With highest quartile of LBP [adjusted OR(aOR)=1.69, 95%CI:1.02~2.81], current drug use (aOR=1.82, 95%CI:1.06~3.12), baseline CD4<200 cells/μL (aOR=3.25, 95%CI:2.13~4.95), HCV coinfection (aOR=2.52, 95%CI:1.41~4.51) and aged over 50 years (aOR=32.66, 95%CI:15.89~66.36) were significantly associated with advanced LF. Liver fibrosis progression (increasing FIB-4) was significantly associated with increasing sCD14 level (β=1.11, 95%CI: 0.97~1.26, P<0.001) with covariates adjustment.
Conclusion: The significant relationship between MT and LF may reveal pathogenic mechanisms and potential intervention targets of liver complications among PLWH in China.
Key words
HIV; microbial translocation; liver fibrosis; LBP; sCD14
