Soluble CD163 Identifies Those at Risk for Increased Hepatic Inflammation & Fibrosis

Kenneth E. Sherman, Heidi L. Meeds, Susan D. Rouster, Enass A. Abdel-Hameed, Jacqueline Hernandez, Javier Tamargo, Jun Chen, Richard L. Ehman, Marianna Baum

Research output: Contribution to journalArticlepeer-review


Background: Liver disease remains a significant cause of morbidity and mortality in HIV-infected persons. Soluble CD163 is a marker of Kupffer cell activation that is highly associated with development of hepatic fibrosis. The relative contributions of HIV-associated systemic immune activation vs other etiologies of injury are poorly characterized. Methods: We utilized subjects in the Miami Adult Studies on HIV (MASH) cohort to evaluate 464 participants including 361 people with HIV (PWH) and 103 hepatitis C virus (HCV)/HIV-uninfected controls. Subjects underwent testing for hepatic fibrosis using both magnetic resonance elastography and the Enhanced Liver Fibrosis Index. Steatosis was evaluated by magnetic resonance imaging-derived proton density fat fraction. Immune activation markers and cytokines were quantitated using Luminex methodologies. Results: Participants with HIV with or without HCV coinfection had higher levels of sCD163 than uninfected controls (P<.05). Soluble sCD163 was highly associated with elevated alanine aminotransferase, a key marker of inflammation/injury and with hepatic fibrosis. Hepatic steatosis was also associated with a cytokine pattern suggestive of Kupffer cell activation but was not associated with an increase in sCD14 or sCD27. Conclusions: Injury and resultant hepatic fibrosis occur by distinct though overlapping mechanistic pathways. In PWH, sCD163 is highly associated with both injury and fibrosis, suggesting that persistent systemic immune activation is a major contributor to long-term outcomes, adding to damage caused by alcohol, steatosis, and other hepatotoxic drug effects.

Original languageEnglish (US)
Article numberofab203
JournalOpen Forum Infectious Diseases
Issue number6
StatePublished - Jun 1 2021


  • fibrosis
  • immune activation
  • liver
  • sCD163
  • steatosis

ASJC Scopus subject areas

  • Oncology
  • Clinical Neurology


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