Lars Jørgen Østergaard

Hyaluronic Acid Levels Predict Risk of Hepatic Encephalopathy and Liver-Related Death in HIV/Viral Hepatitis Coinfected Patients

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

  • Lars Peters, University of Copenhagen
  • ,
  • Amanda Mocroft, University College London
  • ,
  • Vincent Soriano, Hospital Carlos III
  • ,
  • Jürgen Rockstroh, University of Bonn
  • ,
  • Andri Rauch, University of Bern
  • ,
  • Anders Karlsson, Karolinska Institutet
  • ,
  • Brygida Knysz, Wroclaw Medical University
  • ,
  • Christian Pradier, CHU de Nice
  • ,
  • Kai Zilmer, West-Tallin Central Hospital, West-Tallinn Central Hospital
  • ,
  • Jens D. Lundgren, University of Copenhagen
  • ,
  • M. Losso, Hospital General de Agudos José María Ramos Mejía
  • ,
  • M. Kundro, Hospital General de Agudos José María Ramos Mejía
  • ,
  • N. Vetter, Pulmologisches Zentrum
  • ,
  • R. Zangerle, Innsbruck Medical University
  • ,
  • I. Karpov, Belarusian State Medical University
  • ,
  • A. Vassilenko, Belarusian State Medical University
  • ,
  • V. M. Mitsura, Gomel State Medical University
  • ,
  • O. Suetnov, Regional AIDS Centre
  • ,
  • N. Clumeck, Saint-Pierre University Hospital
  • ,
  • S. De Wit, Saint-Pierre University Hospital
  • ,
  • M. Delforge, Saint-Pierre University Hospital
  • ,
  • R. Colebunders, Institute of Tropical Medicine Antwerp
  • ,
  • L. Vandekerckhove, Ghent University
  • ,
  • V. Hadziosmanovic, Klinicki Centar Univerziteta Sarajevo
  • ,
  • K. Kostov, Infectious Diseases Hospital
  • ,
  • J. Begovac, University of Zagreb
  • ,
  • L. Machala, Charles University
  • ,
  • D. Jilich, Charles University
  • ,
  • D. Sedlacek, Charles University
  • ,
  • J. Nielsen, University of Copenhagen
  • ,
  • G. Kronborg, University of Copenhagen
  • ,
  • T. Benfield, University of Copenhagen
  • ,
  • M. Larsen, University of Copenhagen
  • ,
  • J. Gerstoft, University of Copenhagen
  • ,
  • T. Katzenstein, University of Copenhagen
  • ,
  • A. B.E. Hansen
  • ,
  • P. Skinhøj, University of Copenhagen
  • ,
  • C. Pedersen, University of Southern Denmark
  • ,
  • L. Ostergaard
  • Jelena Smidt, Nakkusosakond Siseklinik
  • ,
  • M. Ristola, University of Helsinki
  • ,
  • C. Katlama, Sorbonne Université
  • ,
  • J. P. Viard, Universite Paris 5
  • ,
  • P. M. Girard, Sorbonne Université
  • ,
  • J. M. Livrozet, Hopital Edouard Herriot
  • ,
  • P. Vanhems, Universite Claude Bernard Lyon 1
  • ,
  • F. Dabis, Institut National de la Santé et de la Recherche Médicale
  • ,
  • D. Neau, Institut National de la Santé et de la Recherche Médicale
  • ,
  • R. Schmidt, Hannover Medical School
  • ,
  • J. van Lunzen, University of Hamburg
  • ,
  • O. Degen, University of Hamburg
  • ,
  • H. J. Stellbrink, IPM Study Center
  • ,
  • S. Staszewski, Goethe University Frankfurt
  • ,
  • J. Bogner, Ludwig Maximilian University of Munich
  • ,
  • G. Fätkenheuer, University of Cologne
  • ,
  • J. Kosmidis, Athens General Hospital
  • ,
  • P. Gargalianos, Athens General Hospital
  • ,
  • G. Xylomenos, Athens General Hospital
  • ,
  • J. Perdios, Athens General Hospital
  • ,
  • G. Panos, 1st IKA Hospital
  • ,
  • A. Filandras, 1st IKA Hospital
  • ,
  • E. Karabatsaki, 1st IKA Hospital
  • ,
  • H. Sambatakou, Ippokration Genereal Hospital
  • ,
  • D. Banhegyi, Szent László Hospital
  • ,
  • F. Mulcahy, Trinity College Dublin
  • ,
  • I. Yust, Tel Aviv Sourasky Medical Center
  • ,
  • D. Turner, Tel Aviv Sourasky Medical Center
  • ,
  • M. Burke, Tel Aviv Sourasky Medical Center
  • ,
  • S. Pollack, Rambam Health Care Campus Israel
  • ,
  • G. Hassoun, Rambam Health Care Campus Israel
  • ,
  • S. Maayan, Hadassah University Medical Centre
  • ,
  • S. Vella, Istituto Superiore di Sanita
  • ,
  • R. Esposito, University of Modena and Reggio Emilia
  • ,
  • I. Mazeu, University of Modena and Reggio Emilia
  • ,
  • C. Mussini, University of Modena and Reggio Emilia
  • ,
  • C. Arici, Ospedali Riuniti Di Bergamo
  • ,
  • R. Pristera, Ospedale Generale Regionale
  • ,
  • F. Mazzotta, Ospedale S Maria Annunziata
  • ,
  • A. Gabbuti, Ospedale S Maria Annunziata
  • ,
  • V. Vullo, University of Rome La Sapienza
  • ,
  • M. Lichtner, University of Rome La Sapienza
  • ,
  • A. Chirianni, Ospedale V. Monaldi
  • ,
  • E. Montesarchio, Ospedale V. Monaldi
  • ,
  • M. Gargiulo, Ospedale V. Monaldi
  • ,
  • G. Antonucci, IRCCS Istituto per le Malattie Infettive Lazzaro Spallanzani - Roma
  • ,
  • A. Testa, IRCCS Istituto per le Malattie Infettive Lazzaro Spallanzani - Roma
  • ,
  • G. D̀offizi, IRCCS Istituto per le Malattie Infettive Lazzaro Spallanzani - Roma
  • ,
  • C. Vlassi, IRCCS Istituto per le Malattie Infettive Lazzaro Spallanzani - Roma
  • ,
  • M. Zaccarelli, IRCCS Istituto per le Malattie Infettive Lazzaro Spallanzani - Roma
  • ,
  • A. Antorini, IRCCS Istituto per le Malattie Infettive Lazzaro Spallanzani - Roma
  • ,
  • A. Lazzarin, IRCCS San Raffaele Scientific Institute
  • ,
  • A. Castagna, IRCCS San Raffaele Scientific Institute
  • ,
  • N. Gianotti, IRCCS San Raffaele Scientific Institute
  • ,
  • M. Galli, Ospedale Luigi Sacco
  • ,
  • A. Ridolfo, Ospedale Luigi Sacco
  • ,
  • A. d'Arminio Monforte, Istituto Di Clinica Malattie Infettive e Tropicale
  • ,
  • B. Rozentale, Infectology Centre of Latvia
  • ,
  • I. Zeltina, Infectology Centre of Latvia
  • ,
  • S. Chaplinskas, Lithuanian AIDS Centre
  • ,
  • T. Staub, Centre Hospitalier
  • ,
  • R. Hemmer, Centre Hospitalier
  • ,
  • P. Reiss, University of Amsterdam
  • ,
  • V. Ormaasen, University of Oslo
  • ,
  • A. Maeland, University of Oslo
  • ,
  • J. Bruun, University of Oslo
  • ,
  • J. Gasiorowski, Wroclaw Medical University
  • ,
  • A. Horban, Centrum Diagnostyki i Terapii AIDS
  • ,
  • E. Bakowska, Centrum Diagnostyki i Terapii AIDS
  • ,
  • A. Grzeszczuk, Medical University of Bialystok
  • ,
  • R. Flisiak, Medical University of Bialystok
  • ,
  • A. Boron-Kaczmarska, Pomeranian Medical University in Szczecin
  • ,
  • M. Pynka, Pomeranian Medical University in Szczecin
  • ,
  • M. Parczewski, Pomeranian Medical University in Szczecin
  • ,
  • M. Beniowski, Osrodek Diagnostyki i Terapii AIDS
  • ,
  • E. Mularska, Osrodek Diagnostyki i Terapii AIDS
  • ,
  • H. Trocha, Medical University of Gdansk
  • ,
  • E. Jablonowska, Wojewodzki Szpital Specjalistyczny
  • ,
  • E. Malolepsza, Wojewodzki Szpital Specjalistyczny
  • ,
  • K. Wojcik, Wojewodzki Szpital Specjalistyczny
  • ,
  • F. Antunes, University of Lisbon
  • ,
  • M. Doroana, University of Lisbon
  • ,
  • L. Caldeira, University of Lisbon
  • ,
  • K. Mansinho, Santa Cruz Hospital
  • ,
  • F. Maltez, Hospital Curry Cabral
  • ,
  • D. Duiculescu, Victor Babes National Institute
  • ,
  • A. Rakhmanova, Medical Academy Botkin Hospital
  • ,
  • N. Zakharova, St Petersburg AIDS Centre
  • ,
  • S. Buzunova, Novgorod Centre for AIDS
  • ,
  • D. Jevtovic, Institute for Infectious and Tropical Diseases
  • ,
  • M. Mokráš, Dérer Hospital
  • ,
  • D. Staneková, Dérer Hospital
  • ,
  • J. Tomazic, University of Ljubljana
  • ,
  • J. González-Lahoz, Hospital Carlos III
  • ,
  • P. Labarga, Hospital Carlos III
  • ,
  • J. Medrano, Hospital Carlos III
  • ,
  • S. Moreno, Hospital Ramon y Cajal
  • ,
  • J. M. Rodriguez, Hospital Ramon y Cajal
  • ,
  • B. Clotet, Autonomous University of Barcelona
  • ,
  • A. Jou, Autonomous University of Barcelona
  • ,
  • R. Paredes, Autonomous University of Barcelona
  • ,
  • C. Tural, Autonomous University of Barcelona
  • ,
  • J. Puig, Autonomous University of Barcelona
  • ,
  • I. Bravo, Autonomous University of Barcelona
  • ,
  • J. M. Gatell, University of Barcelona
  • ,
  • J. M. Miró, University of Barcelona
  • ,
  • P. Domingo, Hospital Sant Pau
  • ,
  • M. Gutierrez, Hospital Sant Pau
  • ,
  • G. Mateo, Hospital Sant Pau
  • ,
  • M. A. Sambeat, Hospital Sant Pau
  • ,
  • A. Blaxhult, Karolinska Institutet
  • ,
  • L. Flamholc, Lund University
  • ,
  • B. Ledergerber, University of Zurich
  • ,
  • R. Weber
  • P. Francioli, University of Lausanne
  • ,
  • M. Cavassini, University of Lausanne
  • ,
  • B. Hirschel, University of Geneva
  • ,
  • E. Boffi, University of Geneva
  • ,
  • H. Furrer, University of Bern
  • ,
  • M. Battegay, University of Basel
  • ,
  • L. Elzi, University of Basel
  • ,
  • E. Kravchenko, Kiev Centre for AIDS
  • ,
  • N. Chentsova, Kiev Centre for AIDS
  • ,
  • V. Frolov, Luhansk State Medical University
  • ,
  • G. Kutsyna, Luhansk State Medical University
  • ,
  • S. Servitskiy, Odessa Region AIDS Center
  • ,
  • M. Krasnov, Kharkiv National Medical University
  • ,
  • S. Barton, Imperial College London
  • ,
  • A. M. Johnson, University College London
  • ,
  • D. Mercey, University College London
  • ,
  • A. Phillips, University College London
  • ,
  • M. A. Johnson, University College London
  • ,
  • M. Murphy, Queen Mary University of London
  • ,
  • J. Weber, Imperial College School of Medicine at St. Mary's
  • ,
  • G. Scullard, Imperial College School of Medicine at St. Mary's
  • ,
  • M. Fisher, Brighton and Sussex University Hospitals NHS Trust
  • ,
  • C. Leen, NHS Lothian

Background:Whereas it is well established that various soluble biomarkers can predict level of liver fibrosis, their ability to predict liver-related clinical outcomes is less clearly established, in particular among HIV/viral hepatitis co-infected persons. We investigated plasma hyaluronic acid's (HA) ability to predict risk of liver-related events (LRE; hepatic coma or liver-related death) in the EuroSIDA study.Methods:Patients included were positive for anti-HCV and/or HBsAg with at least one available plasma sample. The earliest collected plasma sample was tested for HA (normal range 0-75 ng/mL) and levels were associated with risk of LRE. Change in HA per year of follow-up was estimated after measuring HA levels in latest sample before the LRE for those experiencing this outcome (cases) and in a random selection of one sixth of the remaining patients (controls).Results:During a median of 8.2 years of follow-up, 84/1252 (6.7%) patients developed a LRE. Baseline median (IQR) HA in those without and with a LRE was 31.8 (17.2-62.6) and 221.6 ng/mL (74.9-611.3), respectively (p<0.0001). After adjustment, HA levels predicted risk of contracting a LRE; incidence rate ratios for HA levels 75-250 or ≥250 vs. <75 ng/mL were 5.22 (95% CI 2.86-9.26, p<0.0007) and 28.22 (95% CI 14.95-46.00, p<0.0001), respectively. Median HA levels increased substantially prior to developing a LRE (107.6 ng/mL, IQR 0.8 to 251.1), but remained stable for controls (1.0 ng/mL, IQR -5.1 to 8.2), (p<0.0001 comparing cases and controls), and greater increases predicted risk of a LRE in adjusted models (p<0.001).Conclusions:An elevated level of plasma HA, particularly if the level further increases over time, substantially increases the risk of contracting LRE over the next five years. HA is an inexpensive, standardized and non-invasive supplement to other methods aimed at identifying HIV/viral hepatitis co-infected patients at risk of hepatic complications.

Original languageEnglish
Article numbere64283
JournalPLOS ONE
Volume8
Issue5
ISSN1932-6203
DOIs
Publication statusPublished - 27 May 2013

See relations at Aarhus University Citationformats

ID: 207065314