Hyaluronic acid levels predict increased risk of non-AIDS death in hepatitis-coinfected persons interrupting antiretroviral therapy in the SMART Study

Lars Peters; Jacqueline Neuhaus; Amanda Mocroft; Vincent Soriano; Jürgen Rockstroh; Gregory Dore; Massimo Puoti; Ellen Tedaldi; Bonaventura Clotet; Bernd Kupfer; Jens D Lundgren; Marina B Klein; SMART Study Group

doi:10.3851/IMP1815

Hyaluronic acid levels predict increased risk of non-AIDS death in hepatitis-coinfected persons interrupting antiretroviral therapy in the SMART Study

Lars Peters, Jacqueline Neuhaus, Amanda Mocroft, Vincent Soriano, Jürgen Rockstroh, Gregory Dore, Massimo Puoti, Ellen Tedaldi, Bonaventura Clotet, Bernd Kupfer, Jens D Lundgren, Marina B Klein, SMART Study Group

12 Citationer (Scopus)

Abstract

Background: In the SMART study, HIV-viral-hepatitiscoinfected persons were, compared with HIV-monoinfected persons, at higher risk of non-AIDS death if randomized to the antiretroviral therapy (ART) interruption strategy. We hypothesized that a marker of liver fibrosis, hyaluronic acid (HA), would be predictive of development of non-AIDSrelated outcomes in coinfected participants in the SMART study. Methods: All participants positive for HCV RNA or hepatitis B surface antigen (HBsAg) and with stored plasma samples were included (n=675). Plasma samples were tested for HA (normal range 0-75 ng/ml) at baseline and months 6, 12 and 24 during follow-up in the drug conservation (DC; interrupt ART until CD4 ⁺ T-cell count &λτ;250) group and the viral suppression (VS; continued use of ART) group. Time to non-AIDS death was investigated using Kaplan-Meier analysis. Results: Overall, 52 (31 in DC and 21 in VS) coinfected participants died during follow-up. Coinfected participants who were randomized to The DC group with baseline HA&γτ;75 ng/ml had a cumulative risk of non-AIDS death of 24.6% after 36 months of follow-up compared with 9.3% for participants randomized to the VS group (P=0.005), while the cumulative risk for coinfected participants with HA&λε;75 ng/ml was 4.1% (DC) and 4.7% (VS; P=0.76). The change in HA from baseline to month 24 was 8.3 ng/ml and 4.7 ng/ml in the DC and VS group (P=0.56), respectively. Conclusions: Interruption of ART was particularly unsafe in HIV-hepatitis-coinfected individuals if plasma HA was increased. HA changed very little during follow-up and was not influenced by differences in CD4 ⁺ T-cell count or HIV viral load.

Originalsprog	Engelsk
Tidsskrift	Antiviral Therapy
Vol/bind	16
Udgave nummer	5
Sider (fra-til)	667-75
Antal sider	9
ISSN	1359-6535
DOI	https://doi.org/10.3851/IMP1815 https://doi.org/10.3851/IMP1815
Status	Udgivet - 1 jan. 2011

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Peters, L., Neuhaus, J., Mocroft, A., Soriano, V., Rockstroh, J., Dore, G., Puoti, M., Tedaldi, E., Clotet, B., Kupfer, B., Lundgren, J. D., Klein, M. B., & SMART Study Group (2011). Hyaluronic acid levels predict increased risk of non-AIDS death in hepatitis-coinfected persons interrupting antiretroviral therapy in the SMART Study. Antiviral Therapy, 16(5), 667-75. https://doi.org/10.3851/IMP1815, https://doi.org/10.3851/IMP1815

Peters, L, Neuhaus, J, Mocroft, A, Soriano, V, Rockstroh, J, Dore, G, Puoti, M, Tedaldi, E, Clotet, B, Kupfer, B, Lundgren, JD, Klein, MB & SMART Study Group 2011, 'Hyaluronic acid levels predict increased risk of non-AIDS death in hepatitis-coinfected persons interrupting antiretroviral therapy in the SMART Study', Antiviral Therapy, bind 16, nr. 5, s. 667-75. https://doi.org/10.3851/IMP1815, https://doi.org/10.3851/IMP1815

@article{c06091f8a06c45dfa5e786c1e9eb0dde,

title = "Hyaluronic acid levels predict increased risk of non-AIDS death in hepatitis-coinfected persons interrupting antiretroviral therapy in the SMART Study",

abstract = "Background: In the SMART study, HIV-viral-hepatitiscoinfected persons were, compared with HIV-monoinfected persons, at higher risk of non-AIDS death if randomized to the antiretroviral therapy (ART) interruption strategy. We hypothesized that a marker of liver fibrosis, hyaluronic acid (HA), would be predictive of development of non-AIDSrelated outcomes in coinfected participants in the SMART study. Methods: All participants positive for HCV RNA or hepatitis B surface antigen (HBsAg) and with stored plasma samples were included (n=675). Plasma samples were tested for HA (normal range 0-75 ng/ml) at baseline and months 6, 12 and 24 during follow-up in the drug conservation (DC; interrupt ART until CD4 + T-cell count &λτ;250) group and the viral suppression (VS; continued use of ART) group. Time to non-AIDS death was investigated using Kaplan-Meier analysis. Results: Overall, 52 (31 in DC and 21 in VS) coinfected participants died during follow-up. Coinfected participants who were randomized to The DC group with baseline HA&γτ;75 ng/ml had a cumulative risk of non-AIDS death of 24.6% after 36 months of follow-up compared with 9.3% for participants randomized to the VS group (P=0.005), while the cumulative risk for coinfected participants with HA&λε;75 ng/ml was 4.1% (DC) and 4.7% (VS; P=0.76). The change in HA from baseline to month 24 was 8.3 ng/ml and 4.7 ng/ml in the DC and VS group (P=0.56), respectively. Conclusions: Interruption of ART was particularly unsafe in HIV-hepatitis-coinfected individuals if plasma HA was increased. HA changed very little during follow-up and was not influenced by differences in CD4 + T-cell count or HIV viral load.",

author = "Lars Peters and Jacqueline Neuhaus and Amanda Mocroft and Vincent Soriano and J{\"u}rgen Rockstroh and Gregory Dore and Massimo Puoti and Ellen Tedaldi and Bonaventura Clotet and Bernd Kupfer and Lundgren, {Jens D} and Klein, {Marina B} and {SMART Study Group}",

year = "2011",

month = jan,

day = "1",

doi = "10.3851/IMP1815",

language = "English",

volume = "16",

pages = "667--75",

journal = "Antiviral Therapy",

issn = "1359-6535",

publisher = "International Medical Press",

number = "5",

}

TY - JOUR

T1 - Hyaluronic acid levels predict increased risk of non-AIDS death in hepatitis-coinfected persons interrupting antiretroviral therapy in the SMART Study

AU - Peters, Lars

AU - Neuhaus, Jacqueline

AU - Mocroft, Amanda

AU - Soriano, Vincent

AU - Rockstroh, Jürgen

AU - Dore, Gregory

AU - Puoti, Massimo

AU - Tedaldi, Ellen

AU - Clotet, Bonaventura

AU - Kupfer, Bernd

AU - Lundgren, Jens D

AU - Klein, Marina B

AU - SMART Study Group

PY - 2011/1/1

Y1 - 2011/1/1

N2 - Background: In the SMART study, HIV-viral-hepatitiscoinfected persons were, compared with HIV-monoinfected persons, at higher risk of non-AIDS death if randomized to the antiretroviral therapy (ART) interruption strategy. We hypothesized that a marker of liver fibrosis, hyaluronic acid (HA), would be predictive of development of non-AIDSrelated outcomes in coinfected participants in the SMART study. Methods: All participants positive for HCV RNA or hepatitis B surface antigen (HBsAg) and with stored plasma samples were included (n=675). Plasma samples were tested for HA (normal range 0-75 ng/ml) at baseline and months 6, 12 and 24 during follow-up in the drug conservation (DC; interrupt ART until CD4 + T-cell count &λτ;250) group and the viral suppression (VS; continued use of ART) group. Time to non-AIDS death was investigated using Kaplan-Meier analysis. Results: Overall, 52 (31 in DC and 21 in VS) coinfected participants died during follow-up. Coinfected participants who were randomized to The DC group with baseline HA&γτ;75 ng/ml had a cumulative risk of non-AIDS death of 24.6% after 36 months of follow-up compared with 9.3% for participants randomized to the VS group (P=0.005), while the cumulative risk for coinfected participants with HA&λε;75 ng/ml was 4.1% (DC) and 4.7% (VS; P=0.76). The change in HA from baseline to month 24 was 8.3 ng/ml and 4.7 ng/ml in the DC and VS group (P=0.56), respectively. Conclusions: Interruption of ART was particularly unsafe in HIV-hepatitis-coinfected individuals if plasma HA was increased. HA changed very little during follow-up and was not influenced by differences in CD4 + T-cell count or HIV viral load.

AB - Background: In the SMART study, HIV-viral-hepatitiscoinfected persons were, compared with HIV-monoinfected persons, at higher risk of non-AIDS death if randomized to the antiretroviral therapy (ART) interruption strategy. We hypothesized that a marker of liver fibrosis, hyaluronic acid (HA), would be predictive of development of non-AIDSrelated outcomes in coinfected participants in the SMART study. Methods: All participants positive for HCV RNA or hepatitis B surface antigen (HBsAg) and with stored plasma samples were included (n=675). Plasma samples were tested for HA (normal range 0-75 ng/ml) at baseline and months 6, 12 and 24 during follow-up in the drug conservation (DC; interrupt ART until CD4 + T-cell count &λτ;250) group and the viral suppression (VS; continued use of ART) group. Time to non-AIDS death was investigated using Kaplan-Meier analysis. Results: Overall, 52 (31 in DC and 21 in VS) coinfected participants died during follow-up. Coinfected participants who were randomized to The DC group with baseline HA&γτ;75 ng/ml had a cumulative risk of non-AIDS death of 24.6% after 36 months of follow-up compared with 9.3% for participants randomized to the VS group (P=0.005), while the cumulative risk for coinfected participants with HA&λε;75 ng/ml was 4.1% (DC) and 4.7% (VS; P=0.76). The change in HA from baseline to month 24 was 8.3 ng/ml and 4.7 ng/ml in the DC and VS group (P=0.56), respectively. Conclusions: Interruption of ART was particularly unsafe in HIV-hepatitis-coinfected individuals if plasma HA was increased. HA changed very little during follow-up and was not influenced by differences in CD4 + T-cell count or HIV viral load.

U2 - 10.3851/IMP1815

DO - 10.3851/IMP1815

M3 - Journal article

SN - 1359-6535

VL - 16

SP - 667

EP - 675

JO - Antiviral Therapy

JF - Antiviral Therapy

IS - 5

ER -

Hyaluronic acid levels predict increased risk of non-AIDS death in hepatitis-coinfected persons interrupting antiretroviral therapy in the SMART Study

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