Minimal residual viremia in HBeAg negative individuals treated with nucleos(t)ide analogues.

<p>Minimal residual viremia in HBeAg negative individuals treated with nucleos(t)ide analogues.</p

Clinical characteristics of patients with viral resistance.

<p>Clinical characteristics of patients with viral resistance.</p

Minimal residual viremia in HBeAg positive individuals treated with nucleos(t)ide analogues.

<p>Minimal residual viremia in HBeAg positive individuals treated with nucleos(t)ide analogues.</p

Minimal residual viremia in untreated HBsAg carriers.

<p>Minimal residual viremia in untreated HBsAg carriers.</p

Minimal residual viremia according to treatment regimen.

<p>Minimal residual viremia according to treatment regimen.</p

Baseline characteristics of the study cohort.

<p>Baseline characteristics of the study cohort.</p

Low PCSK9 levels are correlated with mortality in patients with end-stage liver disease

<div><p>Introduction</p><p>Proprotein convertase subtilisin/kexin type 9 (PCSK9) plays a key role in the cholesterol metabolism and is synthesized by the liver. It interacts with the LDL-receptor to promote its degradation. The model of end-stage liver disease (MELD) score is a well-established tool to estimate the risk of mortality in patients with end-stage chronic liver disease. The study aims to assess the associations between PCSK9, hypocholesterinemia, liver synthesis, cholestasis, MELD score and mortality in patients with end-stage liver disease.</p><p>Methods</p><p>Serum samples were obtained from 74 patients with severe liver disease. The study participants were aged between 23 and 70 y (mean: 55.8 y; 47 males [63.5%], 27 females [36.5%]). Samples were selected from those with a wide range of MELD scores (7 to 40).</p><p>Patients that underwent liver transplantation (17 / 74) were censored at the time of transplantation for mortality analysis.</p><p>Results</p><p>PCSK9 values ranged from 31.47 ng/mL to 261.64 ng/mL. The median value was 106.39 ng/ml. PCSK9 was negatively correlated with markers of liver function and cholestasis (INR, bilirubin). Over a 90-d follow-up, 15 of 57 (26,3%) patients died within the 90-d follow-up without receiving liver transplantation. Thirteen of 31 (42%) patients with PCSK9 levels below the median died compared to 2/26 (8%) patients with higher PCSK9 levels (<i>p</i> = 0.006). In this cohort, there were no significant correlations between PCSK9, cholesterol, its precursors and several phytosterols.</p><p>Conclusions</p><p>Low PCSK9 serum concentrations were associated with higher mortality in patients with end-stage liver disease. The mean PCSK9 levels in the study population were much lower than those found in normal or healthy populations. Further studies are required to acquire a more detailed understanding of the role of PCSK9 in liver-related mortality.</p></div

PCSK9 levels below the median (<106.39 ng/mL) were significantly associated with higher mortality during the 90-d follow-up (<i>p</i> = 0.002).

<p>(+ indicates censored patients due to liver transplantation).</p

Multivariate logistic regression of baseline predictors (age, HCV RNA concentration, liver fibrosis, <i>IL28B</i> rs12979860 CC and rs8099917 TT genotype, and <i>IFN-L4</i> ss469415590 TT/TT genotype) in genotype 1 infected patients.

<p>GT – genotype; BL – baseline; CI – confidence interval; n. s. – not significant.</p><p>Multivariate logistic regression of baseline predictors (age, HCV RNA concentration, liver fibrosis, <i>IL28B</i> rs12979860 CC and rs8099917 TT genotype, and <i>IFN-L4</i> ss469415590 TT/TT genotype) in genotype 1 infected patients.</p

Comparison of the levels of different biomarkers in patients with PCSK9 levels above and below the median value.

<p>Comparison of the levels of different biomarkers in patients with PCSK9 levels above and below the median value.</p