Publications & Reports

Biomarkers of inflammation and coagulation are associated with mortality and hepatitis flares in persons co-infected with HIV and hepatitis viruses.

Andrade BB, Hullsiek KH, Boulware DR, Rupert A, French MA, Ruxrungtham K, Montes ML, Price H, Barreiro P, Audsley J, Sher A, Lewin SR, Sereti I; for the INSIGHT Study Group.
Immunobiology Section, Laboratory of Parasitic Diseases, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, United States.


Background. Hepatitis C (HCV) or B virus (HBV) co-infection with HIV increases mortality risk over either infection alone and is frequently associated with hepatitis flares upon antiretroviral therapy (ART) initiation.Methods. Retrospective cohort study of 287 HIV-positive persons co-infected with HBV or HCV (HBV n=70; HCV n=207; HBV+HCV n=10) who had pre-ART plasma samples evaluated for biomarkers associated with death (within 4 years) and/or hepatitis flare (within 4 months) after ART initiation. A predictive biomarker risk score was calculated.Results. 48 deaths and 50 hepatitis flares occurred. Non-survivors were older with more prior AIDS events and higher pre-ART triglycerides and AST levels. Detectable hyaluronic acid and higher D-dimer, IL-6, IL-8, and sCD14 levels were associated with death in univariate models and with a composite biomarker risk score. Risk of hepatitis flares was higher with HBV co-infection (24.3%) or both HBV and HCV (50%) displayed than with HCV co-infection only (13.5%). Higher levels of ALT and interleukin (IL)-10 were also associated with hepatitis flares.Conclusion. Among HIV patients co-infected with HBV and/or HCV initiating ART, biomarkers of inflammation and coagulation are associated with an increased risk of death while HBV co-infection and higher pre-ART IL-10 levels are associated with hepatitis flares.

Full text is available at link on right hand side of page. This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Journal of Infectious Diseases following peer review. The definitive publisher-authenticated version is available online at:


  • Journal: The Journal of Infectious Diseases
  • Published: 18/01/2013
  • Volume: 207
  • Issue: 9
  • Pagination: 1379-1388