%0 Journal Article 
%A de Oca Arjona, Montserrat Montes
%A Márquez Coello, María de las Mercedes
%A Soto, María José
%A Rodríguez-Ramos, Claudio
%A Terrón, Alberto
%A Vergara, Antonio
%A Arizcorreta, Ana
%A Fernández Gutiérrez del Alamo, Clotilde
%A Girón González, José Antonio
%T Bacterial translocation in HIV-infected patients with HCV cirrhosis: implication in hemodynamic alterations and mortality.
%D 2011
%@ 1525-4135
%U http://hdl.handle.net/10498/34952
%X Objective: Analysis of the influence of portal hypertension on intestinal permeability in HIV-infected patients with hepatitis C virus (HCV)–related cirrhosis and of the prognostic significance of consequent macrophage activation.
Methods: Twenty HIV-monoinfected patients, 70 patients with HIV-HCV coinfection, 20 of them with compensated and 50 with decompensated cirrhosis, and 20 healthy controls were evaluated for intestinal permeability [measured by lipopolysaccharide-binding protein (LBP) serum levels], macrophage activation [soluble CD14, soluble tumour necrosis factor receptor 55 Kd, and interleukin 6 (IL-6)], and activation of the rennin-angiotensin–aldosterone axis. Patients with decompensated cirrhosis were monitored for a median period of 429 days to analyze the prognostic factors implicated in survival.
Results: Patients with decompensated cirrhosis show increased LBP levels compared with HIV-monoinfected patients. Patients with increased LBP concentration showed elevated soluble CD14, soluble tumour necrosis factor receptor 55 Kd, and IL-6 levels. Twenty-two patients died, from liver-related causes, during the follow-up, and 2 more underwent liver transplantation. Child-Pugh index, CD4 T-cell count, plasma aldosterone and serum IL-6 concentrations indepen- dently predicted liver-related mortality.Conclusions: Increased intestinal permeability, as measured by serum LBP levels, observed in patients with HIV infection is significantly higher in patients with decompensated liver cirrhosis. Proinflammatory cytokines (IL-6) are prognostic markers of HIV-HCV–coinfected patients with decompensated cirrhosis.
%~ Universidad de Cádiz