Table 4. Chronic liver disease.
| Author, year, Location | Study design | Age | % male | HIV Virological Control | NCD Examined | Main findings | |
|---|---|---|---|---|---|---|---|
| 1 | Jenabian 2016, Canada | 1. A cross-sectional analysis of the Canadian Coinfection Cohort of PWH (n = 14), HIV/HCV coinfection (n = 90), people without HIV and HCV (n = 12) 2. longitudinal cohort study of HIV/HCV coinfected before and after SVR (n = 34) |
Years (mean, SD) PWH 46 +- 8, HIV—48 +- 8 |
86% | 100% undetectable/ suppressed viral load | Liver fibrosis measurement using APRI score; Plasma measurement of IP-10, IL-6 and insulin. |
HIV/HCV coinfection had decreased levels of Trp and increased KTR. Also had increased Kynurenine levels in fibrotic patients, that correlated with APRI scores, IP-10 and insulin levels. HIV viremia but not HCV viremia was correlated with Trp catabolism. I-FABP, LBP and sCD14 were higher in HIV/ HCV and HIV groups. Successful HCV treatment improved APRI score, markers of disease progression and MT although elevated Trp catabolism remained unchanged 6 months after SVR. |
| 2 | Balagopal 2008, USA | Cross-sectional analysis within 2 Cohort studies: The AIDS Link to Intravenous Experience [ALIVE] Cohort and the Risk Evaluation Assessment of Community Health (REACH) Cohort. PWH (n = 28),HCV (n = 88), uninfected (n = 60) | Years (mean, SD) HIV+ 35.8 ± 6.4, cirrhosis, 50.5 ¬± 6.2, non-cirrhotic 41.7 ¬± 6.0 HCV+ 4.4 ¬± 3.0 |
73% | Viral load not reported | Liver fibrosis | LPS, sCD14 and AAL were strongly associated with HCV-related liver disease progression (cirrhosis) AAL, a marker of liver disease in HCV-infected persons, was positively correlated with LPS and sCD14. HCV seroconversion is not significantly associated with MT. |
| 3 | Jinato 2020, Thailand | RCT of 1. HCV moninfection (n = 62), 2. HIV/ HCV coinfected (n = 24) and 3. uninfected (n = 20) pre and post treatment with an elbasvir-grazoprevir (EBR/GZR) combination | Years (mean, SD) 1. 50.3 (10.8), 2. 44.2 (7.5), 3.47.8 (9) |
70% | 100% undetectable/ suppressed viral load | Hepatitis C | Pretreatment α-diversity between HCV and HIV/HCV groups did not differ but was less diverse from those of healthy controls. In the HCV group, DAA therapy was associated with improved gut diversity and enrichment of Parabacteroides and Subdoligranulum) and the reduction of Eubacterium. In HIV/ HCV group, DAA therapy was associated with increased abundance of Lachnospira and Subdoligranulum |
| 4 | Chuaypen 2020, Thailand | Cross sectional study of people with HCV (n = 58) and HIV/HCV (n = 28) | NA | NA | Viral load not reported | Hepatitis C and measures of cirrhosis and fibrosis | No differences in diversity between groups. HIV/ HCV group had lower relative abundance of genus Faecalibacteria and Blautia Cirrhosis+ showed significant increase in Agathobacter and decrease in Lachnoclostridium when compared to cirrhosis-. Lachnospira was significantly higher in HIV/HCV cirrhotic patients when compared with HCV cirrhotic patients. |
| 5 | Maurice 2019, UK | Case control study of 1. PWH & liver disease (n = 33), 2. PWH without liver disease (n = 29), 3. Healthy controls (n = 17) |
Years (mean, SD) 1. 46.4(12.4) 2. 48.3 (11), 3. 48 (36.5–53.5) |
96% | 100% undetectable/ suppressed viral load | Liver biopsy proven MAFLD graded according to the NASH CRN scoring system; Brunt criteria for liver fibrosis; Measurement of IL-6, TNF α—receptor 2, adiponectin, leptin; |
sCD14 was associated with MAFLD and liver fibrosis stage MAFLD cases in PWH had higher levels of sCD14, sCD163, leptin and LAR with lower adiponectin. sCD14, sCD163 and LAR, a marker of adipose tissue dysfunction and insulin resistance increased with fibrosis stage and correlated with waist circumference. |
| 6 | Kardashian 2019, USA | Cross sectional study of the WIHS cohort of 1. PWH (n = 59), 2. HIV/HCV coinfection (n = 42), 3. uninfected controls (n = 36) |
Years (media, IQR) 1. (46–55), 2. 52 (47–57), 3. 42 (37–53) |
0% | 1. PWH 48 (20–139), 2. HIV/HCV co-infection 80 (41–871) (median, IQR) copies/mL |
VAT and SAT by MRI. HOMA-IR. Hepatic steatosis as assessed by MRS and Fibrosis calculation via FIB4 |
KTR was highest in the HIV/HCV-group, followed by PWH, then the uninfected group. PWH and HIV/HCV coinfection had higher FIB-4 scores than the uninfected group. A greater kynurenine level (per doubling), was associated with 29.6% greater FIB-4. Higher KTR was significantly associated with LSM. HIV/HCV coinfection was associated with a 94% higher LSM. |
| 7 | Martinez-sands 2023 | Cross sectional study of 1. 30 HIV+MASLD+, 2. 30 HIV+MASLD- and 3. 20 HIV-MASLD+ |
Years (median, IQR) 1. 54 (43,59) 2. 53 (45, 56) 3. 56 (51, 68) |
80% | Viral load not reported | Presence of transaminitis Liver Fibroscan |
Higher α-diversity in those with MAFLD Distinct beta diversity in MAFLD in both PWH and HIV negative The most abundant genera in MAFLD- were Prevotella, Bacteroides, Dialister, Acidaminococcis, Alloprevotella and Catenibacterium; in MAFLD+, the most enriched genera were Ruminococcis, Streptococcus, Holdemanella, Blautia and Lactobacillus. |
| 8. | Martin 2023 | Cross sectional study of the MASH Cohort of PWH who use cocaine or no drugs at all 1.36 PWH with FIB-4 < 1.45 2. 14 PWH with FIB-4 ≥ 1.45 |
Years (mean, SD) 1.54.5 ± 7.5 2. 56.2 ± 4.6 |
58% | 68% undetectable/ suppressed viral load | 24 hour dietary recall Fibrosis calculation via FIB4 and liver enzyme measurements |
Healthy eating index score was lower than the national average. Compared to participants with FIB-4 ≥ 1.45, participants with FIB-4 < 1.45 had significantly higher intake of dairy The RA of Ruminococcaceae, Roseburia species, and Lachnospiraceae were higher in participants with FIB-4 < 1.45 The RA of the Bacteroidales and Cardiobacteriales orders, Bacteroidia class, Bacteroidetes phylum, Cardiobacteriaceae family, and Cardiobacterium genus were higher in those with FIB-4 ≥ 1.45 |
Abbreviations: AAL, Aleuria aurantia lectin; APRI, aspartate aminotransaminase to platelet ratio; CRN, Clinical Research Network; hsCRP, high‐sensitivity C‐reactive protein; DAA, direct acting antivirals; FIB-4, fibrosis 4,HCV; hepatitis C virus; IL-6, interleukin‐6; KTR, Kynurenine to Tryptophan Ratio; LAR, Leptin to adiponectin ratio; LPS, lipopolysaccharide; LSM, Liver Stiffness Measurement; MRS, magnetic resonance spectroscopy; MT, microbial translocation, RCT, Randomised controlled trial; SAT, subcutaneous adipose tissue; sCD14, soluble CD14; Trp, Tryptophan; VAT, Visceral adipose tissue