title: Liver fibrosis, microbial translocation and immune activation markers in HIV and HCV infections and in HIV/HCV co-infection.
abstract: BACKGROUND
  Liver fibrosis is accelerated in patients co-infected with human immunodeficiency virus and hepatitis C viruses.
  
  
  OBJECTIVE
  We investigated the correlation between liver fibrosis, immune activation and microbial translocation.
  
  
  METHODS
  This cross-sectional study included patients with hepatitis C virus (HCV) and human immunodeficiency virus (HIV) mono-infections, HIV/HCV co-infection, and healthy controls (20 subjects/group). Peripheral blood was analysed to determine the levels of Forkhead box 3 (Foxp3) T cells, TGF-β1, CD14 (soluble and surface isoforms), IL-17 and bacterial translocation products. These measurements were correlated to the severity of liver fibrosis, measured with the FIB-4 score and transient elastography.
  
  
  RESULTS
  Foxp3T cell levels were significantly elevated in HIV mono-infected and co-infected groups (p<0.0005). FIB-4 and liver stiffness values inversely correlated with TGF-β1 (p=0.0155 and p=0.0498). Bacterial DNA differed significantly in the HIV-positive compared to the other groups: HIV/HCV co-infected subjects had significantly higher serum levels of bacterial translocation products, CD14, and IL-17 levels (p<0.001).
  
  
  CONCLUSIONS
  Fibrosis stage in HIV/HCV co-infection may be influenced by immune activation due either by viral infections or to bacterial translocation.
authors.affiliation: Department of Infectious Diseases, University of Pavia, IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Sacchi
authors.affiliation: Department of Infectious Diseases, University of Pavia, IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Cima
authors.affiliation: Department of Infectious Diseases, University of Pavia, IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Corbella
authors.affiliation: Molecular and Virology Unit, IRCCS Policlinico San Matteo, Pavia, Italy; Laboratory of Biotechnology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Giuditta
authors.initials: G
authors.lastname: Comolli
authors.affiliation: Molecular and Virology Unit, IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Chiesa
authors.affiliation: Molecular and Virology Unit, IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Fausto
authors.initials: F
authors.lastname: Baldanti
authors.affiliation: Unit of Epidemiology and Biometry, IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Catherine
authors.initials: C
authors.lastname: Klersy
authors.affiliation: Department of Infectious Diseases, University of Pavia, IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Novati
authors.affiliation: Department of Infectious Diseases, University of Pavia, IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Mulatto
authors.affiliation: Department of Infectious Diseases, University of Pavia, IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Mara
authors.initials: M
authors.lastname: Mariconti
authors.affiliation: DIVET University of Milan, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Bazzocchi
authors.affiliation: Hospital Niguarda Ca'Granda, Milan, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Puoti
authors.affiliation: Microbiology Institution, University of Pavia, Italy; Department of Paediatrics, University of Pavia, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Pagani
authors.affiliation: Department of Infectious Diseases, University of Pavia, IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Filice
authors.affiliation: Department of Infectious Diseases, University of Pavia, IRCCS Policlinico San Matteo, Pavia, Italy; Department of Paediatrics, University of Pavia, Italy. Electronic address: raffaele.bruno@unipv.it.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Bruno
mesh_terms: D000328:Adult; D018988:Bacterial Translocation; D015415:Biomarkers / Q000097:blood; D015496:CD4-Positive T-Lymphocytes / Q000166:cytology; D016022:Case-Control Studies; D060085:Coinfection; D003430:Cross-Sectional Studies; D004269:DNA, Bacterial / Q000235:genetics; D054459:Elasticity Imaging Techniques; D005260:Female; D015658:HIV Infections / Q000276:immunology*; D016174:Hepacivirus; D006526:Hepatitis C / Q000276:immunology*; D006801:Humans; D020381:Interleukin-17 / Q000097:blood; D016014:Linear Models; D018950:Lipopolysaccharide Receptors / Q000097:blood; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000235:genetics; D053773:Transforming Growth Factor beta1 / Q000097:blood
chemical_list: D015415:Biomarkers; D004269:DNA, Bacterial; D020381:Interleukin-17; D018950:Lipopolysaccharide Receptors; D012367:RNA, Viral; D053773:Transforming Growth Factor beta1
keywords: Bacterial translocation; HIV immunity; HIV/HCV co-infection; Liver fibrosis