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- Title
Metabolomic Signature as a Predictor of Liver Disease Events in Patients With HIV/HCV Coinfection.
- Authors
Naggie, Susanna; Lusk, Sam; Thompson, J Will; Mock, Meredith; Moylan, Cynthia; Lucas, Joseph E; Dubois, Laura; John-Williams, Lisa St; Moseley, M Arthur; Patel, Keyur; St John-Williams, Lisa
- Abstract
<bold>Background: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusions: </bold>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.
- Subjects
METABOLOMICS; LIVER diseases; HIV; HIV-positive persons; MIXED infections; BLOODBORNE infections; AMINO acid metabolism; HIV infection complications; BIOLOGICAL models; PREDICTIVE tests; METABOLISM; HEPATITIS C; CASE-control method; PROGNOSIS; RESEARCH funding; LIVER failure; FATTY acids; DISEASE complications
- Publication
Journal of Infectious Diseases, 2020, Vol 222, Issue 12, p2012
- ISSN
0022-1899
- Publication type
journal article
- DOI
10.1093/infdis/jiaa316