Jinsong Huang

Liver dysfunction, which serves as a critical indicator of advanced liver disease and a driver of mortality in PLWH, is frequently accompanied by perturbations in serum potassium homeostasis. This study aims to investigate the association between serum potassium and liver dysfunction in PLWH, with identifying potential indicative value for risk stratification of hepatic outcomes. A total of 2,725 PLWHs, with 10,718 measurements of serum potassium, were enrolled in this study. Piecewise linear mixed-effect model with smoothing function and Cox regression analysis were used to identify the association of serum potassium with liver dysfunction. A U-shaped relationship was identified between serum potassium and liver dysfunction, with a threshold of 4.25 mmol/L. Participants with baseline potassium > 4.25 mmol/L had a 27% (95% CI: 1.04–1.54) higher risk of mild liver dysfunction and a 48% (95% CI: 1.01–2.14) higher risk of severe liver dysfunction, which were confirmed by Kaplan-Meier analyses. The study establishes serum potassium concentration as an independent predictor of liver dysfunction in PLWHs, highlighting the importance of potassium monitoring and management for this population.

Objective: To explore the value of the neutrophil CD64 (nCD64) index, monocytic HLA-DR (mHLA-DR), and the percentage of CD14⁺ monocytes in the prognosis of Coronavirus disease 2019 (COVID-19). Methods: Fifty-seven COVID-19 patients from December 2022 to November 2023 were divided into two groups: non-severe group (mild or moderate cases) and severe group (severe or critical cases). Among them, 17 patients were deceased. Flow cytometry was employed to detect the levels of nCD64 index, mHLA-DR, and CD14⁺monocyte percentage in blood. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of mHLA-DR, nCD64 index, and CD14⁺ monocyte percentage for COVID-19 prognosis. Results: The expression levels of mHLA-DR and the percentage of CD14⁺ monocytes in non-severe COVID-19 patients were significantly higher than those in severe and deceased patients (P < 0.05). In contrast, the nCD64 index in non-severe patients was significantly lower than that in severe and deceased patients (P< 0.05). The expression level of mHLA-DR and the percentage of CD14⁺ monocytes in deceased patients were significantly lower than those in surviving patients (P< 0.001), while the nCD64 index level in surviving patients was significantly lower than that in deceased patients (P< 0.001). The area under the curve (AUC) for the nCD64 index, mHLA-DR and the percentage of CD14⁺ monocytes were 0.850, 0.779 and 0.871, respectively. Patients with CD14⁺ monocyte percentage > 4.9%, mHLA-DR value > 16720.5, and nCD64 index < 5.87 had a good prognosis value (P < 0.05). Conclusion: The nCD64 index, mHLA-DR level, and percentage of CD14⁺ monocytes may serve as biomarkers for predicting clinical outcomes in COVID-19 patients.

This letter to the editor relates to the study entitled “Tenofovir amibufenamide vs tenofovir alafenamide for treating chronic hepatitis B: A real-world study”, which was recently published by Peng et al . Hepatitis B virus infection represents a significant health burden worldwide and can lead to cirrhosis and even liver cancer. The antiviral drugs currently used to treat patients with chronic hepatitis B infection still have many side effects, so it is crucial to identify safe and effective drugs to inhibit viral replication.

Coronavirus disease 2019 (COVID-19) patients with liver dysfunction (LD) have a higher chance of developing severe and critical disease. The routine hepatic biochemical parameters ALT, AST, GGT, and TBIL have limitations in reflecting COVID-19–related LD. In this study, we performed proteomic analysis on 397 serum samples from 98 COVID-19 patients to identify new biomarkers for LD. We then established 19 simple machine learning models using proteomic measurements and clinical variables to predict LD in a development cohort of 74 COVID-19 patients with normal hepatic biochemical parameters. The model based on the biomarker ANGL3 and sex (AS) exhibited the best discrimination (time-dependent AUCs: 0.60–0.80), calibration, and net benefit in the development cohort, and the accuracy of this model was 69.0–73.8% in an independent cohort. The AS model exhibits great potential in supporting optimization of therapeutic strategies for COVID-19 patients with a high risk of LD. This model is publicly available athttps://xixihospital-liufang.shinyapps.io/DynNomapp/.

The occurrence of re-positive Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in discharged patients infected with Omicron is common. But, the pote

Background: The data of the impact of tenofovir (TDF) on kidney damage in Chinese HIV-1 infected patients are limited. Objective: The study aims to evaluate the incidence and risk factors of stage 3 chronic kidney disease (CKD) and rapid kidney function decline (RKFD) among Chinese HIV-1 infected patients starting with a TDF-based regimen. Method: We enrolled 797 TDF-initiated HIV-1-infected patients in a Chinese cohort. Kidney dysfunctions were defined as stage 3 CKD (eGFR < 60 mL/min/1.73 m2 during follow-up) and RKFD (eGFR decline > 10 mL/min/1.73 m2/year). A linear mixed-effects model was used to quantify the average eGFR change per 48 weeks. A generalized estimating equation regression analysis was conducted to determine the risk factors associated with renal dysfunction. The method of multiple imputations was used to reduce the bias caused by missing data. Results: In this retrospective study, 14 (2%) patients experienced stage 3 CKD, and 272 (34%) individuals experienced RKFD during a median of 26 (IQR, 4-78; maximum 325) weeks follow-up period. The mean loss in eGFR per 48 weeks increased consistently over time, from -2.59 mL/min/1.73 m2 before 48 weeks to -17.61 mL/min/1.73 m2 after 288 weeks. For every 10 mL/min/1.73 m2 increase of eGFR, the risk of RKFD increased by 29% (95%CI: 18%, 40%). Each 10 years older and every 10 mL/min/1.73 m2 higher in baseline eGFR, the risk of stage 3 CKD increased to 1.56 (95% CI: 1.00, 2.43) and decreased by 65% (95% CI: 48%, 76%), respectively. Anemia and higher viral load were significantly associated with RKFD. The results were robust across a range of multiple imputation analyses. Conclusions: TDF-associated CKD is rare in HIV-1 infected Chinese adults. Longer TDF-exposed patients are more likely to have renal dysfunction, especially those with older age, anemia, lower baseline eGFR, and higher viral load.