Metabolomic Signature as a Predictor of Liver Disease Events in Patients With HIV/HCV Coinfection.

Journal Article (Journal Article)

BACKGROUND: Advanced liver disease due to hepatitis C virus (HCV) is a leading cause of human immunodeficiency virus (HIV)-related morbidity and mortality. There remains a need to develop noninvasive predictors of clinical outcomes in persons with HIV/HCV coinfection. METHODS: We conducted a nested case-control study in 126 patients with HIV/HCV and utilized multiple quantitative metabolomic assays to identify a prognostic profile that predicts end-stage liver disease (ESLD) events including ascites, hepatic encephalopathy, hepatocellular carcinoma, esophageal variceal bleed, and spontaneous bacterial peritonitis. Each analyte class was included in predictive modeling, and area under the receiver operator characteristic curves (AUC) and accuracy were determined. RESULTS: The baseline model including demographic and clinical data had an AUC of 0.79. Three models (baseline plus amino acids, lipid metabolites, or all combined metabolites) had very good accuracy (AUC, 0.84-0.89) in differentiating patients at risk of developing an ESLD complication up to 2 years in advance. The all combined metabolites model had sensitivity 0.70, specificity 0.85, positive likelihood ratio 4.78, and negative likelihood ratio 0.35. CONCLUSIONS: We report that quantification of a novel set of metabolites may allow earlier identification of patients with HIV/HCV who have the greatest risk of developing ESLD clinical events.

Full Text

Duke Authors

Cited Authors

  • Naggie, S; Lusk, S; Thompson, JW; Mock, M; Moylan, C; Lucas, JE; Dubois, L; St John-Williams, L; Moseley, MA; Patel, K

Published Date

  • November 13, 2020

Published In

Volume / Issue

  • 222 / 12

Start / End Page

  • 2012 - 2020

PubMed ID

  • 32502252

Pubmed Central ID

  • PMC7661766

Electronic International Standard Serial Number (EISSN)

  • 1537-6613

Digital Object Identifier (DOI)

  • 10.1093/infdis/jiaa316


  • eng

Conference Location

  • United States