Contributions to Hepatic Fibrosis in HIV-HCV Coinfected and HCV Monoinfected Patients

• Published in: The American journal of gastroenterology Vol. 101; no. 7; pp. 1509 - 1515
• Main Authors: MONTO, Alexander, KAKAR, Sanjay, DOVE, Lorna M, BOSTROM, Alan, MILLER, Erica L, WRIGHT, Teresa L
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell Publishing 01.07.2006; Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins
• Subjects: Biological and medical sciences; Biopsy; Body Mass Index; Cross-Sectional Studies; Disease Progression; Female; Fibrosis - pathology; Gastroenterology; Gastroenterology. Liver. Pancreas. Abdomen; Hepatitis C virus; Hepatitis C, Chronic - complications; Hepatitis C, Chronic - pathology; HIV Infections - complications; HIV Infections - pathology; Human immunodeficiency virus; Humans; Linear Models; Liver Diseases - virology; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; Other diseases. Semiology; Retrospective Studies; Risk Factors; Severity of Illness Index; Statistics, Nonparametric; Human; Hepatic fibrosis; Digestive diseases; Hepatic disease; Gastroenterology
• ISSN: 0002-9270; 1572-0241
• DOI: 10.1111/j.1572-0241.2006.00613.x

The aim of this study was to further explore the severity of liver disease and its predictors in a cohort of hepatitis C virus (HCV) infected patients, some of whom were coinfected with the human immunodeficiency virus (HIV). This is a retrospective, cross-sectional study of patients undergoing liver biopsy to stage HCV disease prior to consideration of anti-HCV therapy. A total of 92 HIV-HCV coinfected and 372 HCV monoinfected patients were included. As might be expected, coinfected patients differed from monoinfected patients in a number of ways, including having lower body mass index (BMI), and lower alcohol intake. Liver disease was very similar between the two groups, with mean fibrosis score of 1.45 u for coinfected and 1.53 u for monoinfected (p = NS). Histological inflammation score dominated multivariate models of fibrosis when it was included in them. When only clinical predictors were used in multivariate models, BMI and type 2 diabetes had independent associations in monoinfected patients, whereas low CD4 count, current or nadir, was the only variable with an independent association in coinfected patients. Coinfected patients do not have uniformly worse liver disease than monoinfected patients. Immune compromise plays an important role in liver disease in coinfected patients, and the role of other clinical factors in liver disease may differ between these two groups, as well.