title: Soluble Adhesion Molecules in Patients Coinfected with HIV and HCV: A Predictor of Outcome.
abstract: BACKGROUND
  Higher serum levels of adhesion molecules (sICAM-1 and sVCAM-1) are associated with advanced liver fibrosis in patients coinfected with human immunodeficiency virus and hepatitis C virus. We assessed the relationship between serum levels of adhesion molecules and liver-related events (LRE) or death, in coinfected patients.
  
  
  METHODS
  We studied clinical characteristics and outcomes of 182 coinfected patients with a baseline liver biopsy (58 with advanced fibrosis) and simultaneous plasma samples who were followed for median of 9 years. We used receiver-operating characteristic (ROC) curves to calculate optimized cutoff values (OCV) of sICAM-1 and sVCAM-1, defined as the values with the highest combination of sensitivity and specificity for LRE. We used multivariate regression analysis to test the association between OCVs of sICAM-1 and sVCAM-1 and outcomes. The variables for adjustment were age, HIV transmission category, liver fibrosis, baseline CD4+ T-cell counts, antiretroviral therapy, and sustained virologic response (SVR).
  
  
  RESULTS
  During the study period 51 patients had SVR, 19 had LRE, and 16 died. The OCVs for LRE were 5.68 Log pg/mL for sICAM-1 and 6.25 Log pg/mL for sVCAM-1, respectively. The adjusted subhazard ratio (aSHR) (95% confidence interval [CI]) of death or LRE, whichever occurred first, for sICAM-1 and sVCAM-1 > OCV were 3.98 ([1.14; 13.89], P = 0.030) and 2.81 ([1.10; 7.19], respectively (P = 0.030).
  
  
  CONCLUSIONS
  Serum levels of sICAM-1 and sVCAM-1 can serve as markers of outcome in HIV/HCV-coinfected patients. Therapies targeting necroinflammatory damage and fibrogenesis may have a role in the management chronic hepatitis C.
authors: Infectious Diseases and HIV Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.|Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
authors: Teresa
authors: T
authors: Aldámiz-Echevarría
authors: Infectious Diseases and HIV Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.|Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
authors: Juan
authors: J
authors: Berenguer
authors: Infectious Diseases and HIV Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.|Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
authors: Pilar
authors: P
authors: Miralles
authors: National Centre of Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
authors: María A
authors: MA
authors: Jiménez-Sousa
authors: Infectious Diseases and HIV Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.|Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
authors: Ana
authors: A
authors: Carrero
authors: National Centre of Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
authors: Daniel
authors: D
authors: Pineda-Tenor
authors: Infectious Diseases and HIV Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.|Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
authors: Cristina
authors: C
authors: Díez
authors: Infectious Diseases and HIV Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.|Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
authors: Francisco
authors: F
authors: Tejerina
authors: Infectious Diseases and HIV Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.|Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
authors: Leire
authors: L
authors: Pérez-Latorre
authors: Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
authors: José M
authors: JM
authors: Bellón
authors: National Centre of Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
authors: Salvador
authors: S
authors: Resino
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D015496:CD4-Positive T-Lymphocytes; D060085:Coinfection; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D006526:Hepatitis C / Q000097:blood / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000473:pathology / Q000821:virology; D008297:Male; D012189:Retrospective Studies; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood*
chemical_list: D015415:Biomarkers; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1