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Cocaine use Associated With Increased Risk for Liver Disease in Patients With HIV

Cocaine use was associated with a higher level of liver apoptosis and liver fibrosis progression after 1-year follow-up in individuals living with HIV, according to an abstract presented at AIDS 2016.

Further, cocaine use was associated with increased HIV viral load and lower BMI in these patients.

“Advances in antiretroviral therapy (ART) have significantly reduced HIV-related mortality; however, substance abuse accelerates HIV-disease and may facilitate progression of liver disease,” Marianna K. Baum, PhD, professor at the Robert Stempel College of Public Health and Social Work at Florida International University, and colleagues wrote. “Hepatic injury results in fibrogenesis, associated with apoptosis, increased levels of plasma [lipopolysaccharide (LPS)] and oxidative stress.”

Marianna K. Baum

As part of the Miami Adult Studies of HIV (MASH) cohort, Baum and colleagues assessed 259 people (mean age, 47.2 years) living with HIV who were not co-infected with hepatitis B or C. At 1-year follow-up, the researchers examined for biomarkers of liver disease, including liver apoptosis, microbial translocation and oxidative stress. They determined substance use by questionnaires and urine toxicology and assessed alcohol use with the Alcohol Use Disorders Identification Test (AUDIT). To confirm any associations, they performed a multivariable logistic regression while adjusting for age, sex, baseline CD4, HIV viral load and alcohol use.

Among cocaine users, HIV viral load was higher (P = .019) and BMI was lower (P = .026) compared with non-cocaine users. Further, cocaine users had higher levels of CK-18 (P = .041), a biomarker for liver apoptosis; higher levels of plasma LPS (P = .0178), a biomarker for microbial translocation; and higher levels of oxidized glutathione (P = .049) and mitochondrial-specific 8-oxo-dG (P = .048), which are both biomarkers for oxidative stress. Higher CK-18 was also associated with increased cocaine use (OR = 5.45; 95% CI, 1.07-28.2).

Cocaine users had higher levels of liver apoptosis, plasma LPS and oxidative stress compared with non-cocaine users, the researchers wrote.

“More frequent use of cocaine was associated with higher level of liver apoptosis and with the progression of liver fibrosis over a 24-month follow-up,” the researchers wrote. “Effective interventions to reduce cocaine consumption and target the biomarkers of liver fibrogenesis are needed to prevent complications of liver disease in people who are living with HIV.” – by Will Offit

Reference:

Baum M, et al. Abstract 172. Presented at: AIDS 2016 Annual Meeting; July 18-22, 2016; Durban, South Africa.

Disclosure: The researchers report no relevant financial disclosures.