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 Citations (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.

Original language	English
Journal	Antiviral Therapy
Volume	16
Issue number	5
Pages (from-to)	667-75
Number of pages	9
ISSN	1359-6535
DOIs	https://doi.org/10.3851/IMP1815 https://doi.org/10.3851/IMP1815
Publication status	Published - 1 Jan 2011

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

Cite this

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, vol. 16, no. 5, pp. 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

Abstract

UN SDGs

Access to Document

Fingerprint

Cite this