Z Gastroenterol 2016; 54 - KV196
DOI: 10.1055/s-0036-1586972

Circulating levels of Pro-C3 reflect liver fibrosis and function in HIV positive patients receiving cART

L Dold 1, MJ Nielsen 2, C Luda 1, C Schwarze-Zander 1, C Bösecke 1, R Schierwagen 1, C Jansen 1, HD Nischalke 1, JC Wasmuth 1, CP Strassburg 1, JK Rockstroh 1, U Spengler 1, J Trebicka 1, DJ Leeming 1
  • 1Universitätsklinikum Bonn, Medizinische Klinik I, Bonn, Deutschland
  • 2Nordic Bioscience, Herlev, Dänemark

Background and aims: Although combined antiretroviral treatment (cART) has improved overall survival of HIV infected patients, liver fibrosis and liver related-mortality still constitute major challenges in HIV positive patients. Collagen type III accumulates in the liver during fibrogenesis. Recent studies could show that circulating levels of fragments of extracellular matrix (ECM) might reflect fibrosis stage and degree of portal hypertension in liver disease. In this study, we analyzed the correlation between liver fibrosis assessed by Fibroscan and levels of the formation marker of collagen type III in HIV positive patients receiving cART.

Methods: 142 HIV positive patients (84.5% male, median age 47 years) were enrolled into the study. Liver stiffness was determined in kPa using Fibroscan. The formation rate of collagen type III could be analyzed by the circulating levels of the Pro-C3 peptide, which is separated from collagen type III at deposition by MMPs. These fragments were measured in peripheral blood by using specific ELISAs for Pro-C3.

Results: Twenty (14.1%) out of the 142 HIV positive patients had relevant fibrosis with a liver stiffness ≥7.5 kPa. Circulating Pro-C3 levels significantly correlated with increasing liver fibrosis assessed by liver stiffness (p = 0.0005), as well as with APRI score (p = 0.015) as a surrogate of liver fibrosis in patients with HIV infection. Interestingly, circulating Pro-C3 levels were significantly correlated with bilirubin (p = 0.022), reduced platelet count (p = 0.0008) and low albumin levels (p = 0.001), suggestion the association of collagen type III deposition with impaired liver function.

Conclusion: The formation marker of collagen type III, Pro-C3 not only reflects liver fibrosis, but also liver function in HIV positive patients receiving cART. Therefore, the circulating levels of Pro-C3 might be suitable to monitor progression of liver fibrosis and deterioration of liver function in HIV positive patients receiving cART.