dc.contributor.author |
Alvarado-Tapias, Edilmar |
dc.contributor.author |
Guarner-Argente, Carlos |
dc.contributor.author |
Oblitas, Elida |
dc.contributor.author |
Sánchez, Elisabet |
dc.contributor.author |
Vidal, Silvia |
dc.contributor.author |
Roman, Eva |
dc.contributor.author |
Concepción, Mar |
dc.contributor.author |
Poca Sans, Maria |
dc.contributor.author |
Gely, Cristina |
dc.contributor.author |
Pavel, Oana |
dc.contributor.author |
Nieto Sáchica, Juan Camilo |
dc.contributor.author |
Juarez, Candido |
dc.contributor.author |
Guarner, Carlos |
dc.contributor.author |
Soriano, German |
dc.contributor.author |
Universitat Autònoma de Barcelona |
dc.date |
2018 |
dc.identifier |
https://ddd.uab.cat/record/187879 |
dc.identifier |
urn:10.4254/wjh.v10.i1.124 |
dc.identifier |
urn:oai:ddd.uab.cat:187879 |
dc.identifier |
urn:oai:egreta.uab.cat:publications/07bc5eb9-6569-45a0-88de-89c025a7fae6 |
dc.identifier |
urn:pmid:29399286 |
dc.identifier |
urn:scopus_id:85041004977 |
dc.identifier |
urn:articleid:19485182v10p124 |
dc.identifier |
urn:pmc-uid:5787676 |
dc.identifier |
urn:pmcid:PMC5787676 |
dc.identifier |
urn:oai:pubmedcentral.nih.gov:5787676 |
dc.format |
application/pdf |
dc.language |
eng |
dc.publisher |
|
dc.relation |
Instituto de Salud Carlos III PI0900357 |
dc.relation |
Instituto de Salud Carlos III CM16-00133 |
dc.relation |
World Journal of Hepatology ; Vol. 10 (january 2018), p. 124-133 |
dc.rights |
open access |
dc.rights |
Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. |
dc.rights |
https://creativecommons.org/licenses/by-nc/4.0/ |
dc.subject |
Cirrhosis |
dc.subject |
Genetic polymorphisms |
dc.subject |
Toll-like receptor 4 |
dc.subject |
Bacterial infections |
dc.subject |
Ascites |
dc.title |
Toll-like receptor 4 polymorphisms and bacterial infections in patients with cirrhosis and ascites |
dc.type |
Article |
dc.description.abstract |
Altres ajuts: Cofinanced by Fondos FEDER (Fondo Europeo de Desarrollo Regional), "Una manera de hacer Europa", European Union, and CERCA Programme, Generalitat de Catalunya; Silvia Vidal was supported by Fondode Investigaciones Sanitarias (FIS) and is a participant in the Program for Stabilization of Investigators of the Direcció d'Estrategia i Coordinació del Departament de Salut, Generalitat de Catalunya. |
dc.description.abstract |
To assess the relationship between the presence of toll-like receptor 4 (TLR4) polymorphisms and bacterial infections in cirrhotic patients with ascites. We prospectively included consecutive patients with cirrhosis and ascites hospitalized during a 6-year period. Patients with human immunodeficiency virus (HIV) infection or any other immunodeficiency, patients with advanced hepatocellular carcinoma (beyond Milan's criteria) or any other condition determining poor short-term prognosis, and patients with a permanent urinary catheter were excluded. The presence of D299G and/or T399I TLR4 polymorphisms was determined by sequencing and related to the incidence and probability of bacterial infections, other complications of cirrhosis, hepatocellular carcinoma, and mortality during follow-up. A multivariate analysis to identify predictive variables of mortality in the whole series was performed. We included 258 patients: 28 (10.8%) were carriers of D299G and/or T399I TLR4 polymorphisms (polymorphism group) and 230 patients were not (wild-type group). The probability of developing any bacterial infection at one-year follow-up was 78% in the polymorphism group and 69% in the wild-type group (P = 0.54). The one-year probability of presenting infections caused by gram-negative bacilli (51% vs 44%, P = 0.68), infections caused by gram-positive cocci (49% vs 40%, P = 0.53), and spontaneous bacterial peritonitis (29% vs 34%, respectively, P = 0.99) did not differ between the two groups. The one-year probability of transplant-free survival was 55% in the polymorphism group and 66% in the wild-type group (P = 0.15). Multivariate analysis confirmed that age, Child-Pugh score, active alcohol intake, previous hepatic encephalopathy, hepatocellular carcinoma and serum creatinine were associated with a higher risk of death during follow-up. Genetic polymorphisms D299G and/or T399I of TLR4 do not seem to play a relevant role in the predisposition of cirrhotic patients with ascites to bacterial infections. |