Evaluation of the Intestinal Fatty Acid Binding Protein (I-FABP) in people with HIV, HCV and HIV/HCV co-infection.
co-infected with HCV and HIV develop cirrhosis more rapidly than people with HCV
mono-infection. One proposed mechanism is that co-infected persons have damaged
intestinal epithelium allowing translocation of bacteria into portal circulation with
consequent hepatic and systemic inflammation. The goal of this study is to compare
Intestinal Fatty Acid Binding Protein (I-FABP), ... read morea marker of intestinal injury, in
healthy controls, people mono-infected with HIV or HCV, and people co-infected with
HIV/HCV. We hypothesized that people with HCV/HCV co-infection will have higher I-FABP
levels than the other study groups. We conducted a cross-sectional study of I-FABP
levels in the above infection groups. HIV-infected participants were required to have
viral suppression on antiretroviral medications. All HCV-infected participants were
required to have evidence of cirrhosis, but decompensated cirrhotics were excluded.
HIV/HCV participants had higher levels of I-FABP compared to the HCV-mono-infected
participants and the healthy participants (median 996 pg/ml vs. 294 pg/ml and 386 pg/ml,
respectively). Adjusting for BMI, FIB4 and age did not impact these findings.
Participants with HIV infection, including mono-infected and co-infected, had
significantly higher levels of I-FABP than participants without HIV (p=0.0001). Markers
of intestinal injury are elevated in HIV/HCV co-infection compared to HCV
mono-infection, supporting the hypothesis that intestinal epithelial integrity and
microbial translocation may play a role in the accelerated development of cirrhosis even
when HIV viral load is fully suppressed. Future larger scale, longitudinal studies
should be pursued to further investigate the causal relationship between intestinal
injury and liver disease.
Thesis (M.S.)--Tufts University, 2014.
Submitted to the Dept. of Clinical & Translational Science.
Advisor: Christine Wanke.
Committee: Tamsin Knox, Barbara McGovern, and Jessica Paulus.
Keyword: Medicine.read less