Incidence and Predictors of Severe Liver Fibrosis in Human Immunodeficiency Virus—Infected Patients with Chronic Hepatitis C: A European Collaborative Study

• Published in: Clinical infectious diseases Vol. 38; no. 1; pp. 128 - 133
• Main Authors: Martín-Carbonero, Luz, Benhamou, Yves, Puoti, Massimo, Berenguer, Juan, Mallolas, José, Quereda, Carmen, Arizcorreta, Ana, Gonzalez, Antonio, Rockstroh, Jurgen, Asensi, Victor, Miralles, Pilar, Laguno, Montse, Moreno, Leonor, Girón, José Antonio, Vogel, Martin, García-Samaniego, Javier, Nuñez, Marina, Romero, Miriam, Moreno, Santiago, de la Cruz, Juan José, Soriano, Vincent
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.01.2004; University of Chicago Press
• Subjects: Adult; Alanine Transaminase - metabolism; antiretroviral therapy; Antiretrovirals; Biological and medical sciences; Biopsies; CD4 antigen; CD4 Lymphocyte Count; Chronic hepatitis; D-Alanine Transaminase; Disease Progression; Female; Fibrosis; Hepacivirus; Hepatitis C virus; Hepatitis C, Chronic - complications; Hepatitis C, Chronic - immunology; Highly active antiretroviral therapy; HIV; HIV Infections - complications; HIV Infections - immunology; HIV/AIDS; Human immunodeficiency virus; Human viral diseases; Humans; Incidence; Infections; Infectious diseases; Liver; Liver Cirrhosis - enzymology; Liver Cirrhosis - epidemiology; Liver Cirrhosis - etiology; Liver Cirrhosis - immunology; Male; Medical sciences; Multivariate Analysis; T lymphocytes; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral hepatitis; Europe; Mixed infection; Hepatic disease; Alcohol; Multivariate analysis; Epidemiology; Incidence; Viral hepatitis A; Immunological investigation; T-Lymphocyte; Antiviral; Serum; Age; Viral hepatitis C; Human; Immunopathology; Enzyme; Critically ill; Transferases; Retroviridae; AIDS; Immune deficiency; Lentivirus; Infection; Virus; Numeration; Chronic; Health center; Biopsy; Transaminases; Viral disease; Fibrosis; Alanine transaminase; Digestive diseases; Human immunodeficiency virus; Flaviviridae; Predictive factor; Severe; Hepatitis C virus; Hepacivirus; Comparative study
• ISSN: 1058-4838; 1537-6591; 1537-6591
• DOI: 10.1086/380130

A study was performed in 10 European health care centers in which 914 patients coinfected with hepatitis C virus (HCV) and human immunodeficiency virus (HIV) who had elevated serum alanine aminotransferase (ALT) levels underwent liver biopsy during the period of 1992 through 2002. Overall, the METAVIR liver fibrosis stage was F0 in 10% of patients, F1 in 33%, F2 in 22%, F3 in 22%, and F4 in 13%. Predictors of severe liver fibrosis (METAVIR stage, F3 or F4) in multivariate analysis were age of >35 years (odds ratio [OR], 2.95; 95% confidence interval [CI], 2.08–4.18), alcohol consumption of >50 g/day (OR, 1.61; 95% CI, 1.1–2.35), and CD4+ T cell count of <500 cells/mm3 (OR, 1.43; 95% CI, 1.03–1.98). Forty-six percent of patients aged >40 years had severe liver fibrosis, compared with 15% of subjects aged <30 years. The use of antiretroviral therapy was not associated with the severity of liver fibrosis. In summary, severe liver fibrosis is frequently found in HCV-HIV-coinfected patients with elevated serum ALT levels, and its severity increases significantly with age. The rate of complications due to end-stage liver disease will inevitably increase in this population, for whom anti-HCV therapy should be considered a priority.