title: HCV coinfection possibly promotes left ventricular dysfunction development:  analysis of brain natriuretic peptide serum levels in HCV/HIV-coinfected and HIV-monoinfected patients.
abstract: OBJECTIVE
  Hepatitis C virus (HCV) has been already linked to possible myocarditis and cardiomyopathy development. The brain natriuretic peptide (BNP) is a sensitive biomarker of left ventricular dysfunction. The present study aimed to evaluate the potential risk of cardiac injury in HIV-infected and HCV/HIV-coinfected patients with or without antiretroviral (ARV) therapy by comparing BNP serum levels in the groups studied.
  
  
  METHODS
  Eighty HIV-infected patients (65 men, 15 women, mean age 40 years; 29 with HCV coinfection, 48 on combined ARV therapy) were included in the cross-sectional study. BNP serum levels were evaluated by enzyme-linked immunosorbent assay. The BNP cut-off level for possible heart failure was 42 fmol/l as in an immunocompetent population.
  
  
  RESULTS
  Seventy-eight (97.5%) patients studied had a BNP concentration above 42 fmol/l; seven patients (8.7%) had a concentration above 168 fmol/l associated with a worse outcome. There was no difference in the mean BNP serum levels in ARV-treated and untreated patients. However, the mean BNP serum level was significantly higher in HCV/HIV-coinfected patients in comparison with HIV-monoinfected patients (160.0 ± 130.9 vs. 81.9 ± 37.2 fmol/l; P<0.0001). There was no relationship between BNP serum levels and HIV viral load, CD4 cell count, sex, age, and abacavir or protease inhibitors use.
  
  
  CONCLUSIONS
  A significant association was found between HCV coinfection and BNP serum level in HIV-infected patients. HCV coinfection possibly enhances the risk of left ventricular dysfunction development in this vulnerable population.
authors: Department of Hepatology and Acquired Immunodeficiencies, Warsaw Medical University, Warsaw, Poland. m.dabrowska@op.pl
authors: Magdalena Monika
authors: MM
authors: Dabrowska
authors: Tomasz
authors: T
authors: Mikula
authors: Alicja
authors: A
authors: Wiercinska-Drapalo
mesh_terms: D000328:Adult; D000368:Aged; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D060085:Coinfection; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology; D006526:Hepatitis C / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D015854:Up-Regulation; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000175:diagnosis / Q000821:virology; D035862:Vulnerable Populations; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents; D015415:Biomarkers; D020097:Natriuretic Peptide, Brain