Z Gastroenterol 2014; 52 - KG073
DOI: 10.1055/s-0034-1386095

P3NP-levels in patients with HIV/HCV-co-infection reflects fibrosis stage and hepatic venous pressure gradient

C Jansen 1, R Schierwagen 1, M Mandorfer 2, P Schwabl 3, E Anadol 1, CP Strassburg 1, M Peck-Radosavljevic 3, J Rockstroh 1, T Reiberger 3, J Trebicka 1
  • 1Universität Bonn, Medizinische Klinik und Poliklinik I, Bonn, Germany
  • 2Nordic Bioscience, Fibrosis Biology and Biomakers, Herlev, Denmark
  • 3Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria

Background: The liver related deaths in patients with HIV/HCV-co-infection are increasing at least partially due to long-term consequences of fibrosis and portal hypertension. However, predictors of fibrosis progression in these patients are poorly investigated and new biomarkers are needed. Our aim was to evaluate extracellular matrix (ECM) degraded fragments in peripheral blood as a biomarker for fibrosis and portal hypertension in patient with HIV/HCV co-infection.

Methods: Fifty-eight (nineteen female) patients with HIV/HCV-co-infection were included in this study. Hepatic venous pressure gradient (HVPG) was measured in forty-three patients using standard methods. The fibrosis stage was determined using Fibroscan (F0 – F1 < 7 kPa/7 < F2 – F3 < 12,5 kPa/F4 > 12,5 kPa) and FIB4-Score. ECM degraded fragments (P3NP, C4 M) in peripheral blood were measured using specific ELISAs.

Results: As previously described, HVPG showed strong correlations with Fibroscan (rs= 0.621; p = 9*10-5) and FIB4-Score (rs= 0.628; p = 7*10-7). Degraded n-terminal propeptide of type III collagen (P3NP) correlated with HVPG (rs= 0.354; p = 0.02), alanine aminotransferase (rs= 0.30; p = 0.038), as well as FIB4-Score (rs= 0.3230; p = 0.035). Degraded type IV collagen (C4 M) levels were significant elevated in patients with HVPG higher then 5 mmHg (p = 0.014).

Conclusion: This study showed for the first time that liver fibrosis and injury might be reflected by P3NP-levels in HIV/HCV-co-infected patients. Interestingly P3Np and C4 M are associated with HVPG in these patients.