Original ResearchClinical—LiverHost Response to Translocated Microbial Products Predicts Outcomes of Patients With HBV or HCV Infection
Section snippets
Study Design
After informed consent, 84 patients with matched plasma and biopsy samples from enrollment with stored post-antiviral treatment plasma samples were selected from an institutional review board–approved study of a viral hepatitis cohort with chronic HBV (n = 21) or chronic HCV (n = 63) infection undergoing standard-of-care antiviral treatment by the Liver Diseases Branch of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at the National Institutes of Health
Study Population
Eighty-four subjects with chronic HBV or HCV infection and 67 uninfected volunteers were included (Table 1). Chronic HBV infection is defined by hepatitis B surface antigen positivity for more than 6 months, serum HBV DNA >20,000 copies/mL, persistent or intermittent elevation in ALT or AST levels, and liver biopsy showing chronic hepatitis with moderate or severe necroinflammation.36 Chronic HCV infection is defined as persistence of HCV RNA in serum 6 months after infection.37 The median age
Discussion
The factors determining the degree of hepatic inflammation and progression to cirrhosis in chronic HBV and HCV infections are not well-defined. Microbial translocation has been suggested as a contributing factor in some human studies and mouse models.5, 6, 7, 8, 9, 20 However, the association of microbial translocation and its local and systemic effects with disease severity and prognosis has not been clearly established. We found that levels of sCD14, a marker of LPS bioreactivity,
Acknowledgments
The authors thank the members of the Cleveland Immunopathogenesis Consortium for their helpful discussions; Levelle Harris, Jason Brenchley, Jacob Estes, and David Morcock for their assistance with quantitative image analysis; and Martha Nason for her assistance with statistical approaches.
C.K. and A.R. contributed equally to this work.
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Conflicts of interest The authors disclose no conflicts.
Funding Grant support received from the intramural programs of National Institute of Allergy and Infectious Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, and National Cancer Institute (National Institutes of Health) and National Institutes of Health grant AI-76174.