The FIB-4 Is a Marker of Monocyte/Macrophage Activation Independently from Severe Hepatic Disease in People Living with HIV on Stable and Successful Treatment.

OBJECTIVES

Despite successful antiretroviral treatment (ART), people living with HIV (PWH) continue experiencing chronic immune activation and comorbidities. We analysed whether the Fibrosis 4 index (FIB-4) is associated with monocyte-macrophage activation in PWH with non-severe hepatic disease.

MATERIALS AND

METHODS

We performed a cross-sectional analysis about factors associated with monocyte-macrophage activation among PWH either on triple or dual ART. Background measurements, comorbid conditions and FIB-4 values were correlated with plasmatic markers of monocyte-macrophage activation (sCD163 and sCD14) using univariate and linear regression analysis.

RESULTS

We included 366 subjects (age 60.5, 75% male, years of HIV infection 24.5, mean FIB-4 1.52, 8% with FIB-4 > 2.67, Body Mass Index 24.5). In univariate analysis, FIB-4 was associated with older age, years of HIV infection, ART duration, lower CD4/CD8 ratio at inclusion, lower nadir CD4, higher sCD14 and sCD163 values, living alone, dyslipidaemia, high blood pressure and diabetes (p < 0.05 for all). In multivariate analysis FIB-4 ≥ 1.3 was associated with sCD163 values ≥ 782 ng/mL [AdjOR 1.85, 95% CI [1.05; 3.33] p = 0.035], independently from CD4 count, ART duration, living alone, hepatitis C, high blood pressure and alcohol.

CONCLUSIONS

The FIB-4 is a simple tool reliable for monocyte-macrophage activation in PWH, able to define subjects with higher risks of complications.