Advanced liver fibrosis in HIV/HCV-coinfected patients on antiretroviral therapy

Daniel Fuster, Ramon Planas, Robert Muga, Angel L. Ballesteros, Justiniano Santos, Jordi Tor, Guillem Sirera, Helena Guardiola, Anna Salas, Eduard Cabré, Isabel Ojanguren, Eva Barluenga, Celestino Rey-Joly, Bonaventura Clotet, Cristina Tural

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Abstract

HIV infection is believed to adversely affect the progression of hepatitis C virus (HCV)-related liver disease. However, information regarding HIV and HCV coinfection in the era of highly active antiretroviral therapy (HAART) is scarce. A cross-sectional study in 75 HCV/HIV-coinfected patients (most of them on HAART) and 75 HCV-monoinfected patients paired by age, sex, and date of liver biopsy analyzed the association of HIV infection with advanced liver fibrosis (Knodell fibrosis stages 3 + 4). The median CD4 cell count in HIV-coinfected patients was 546 cells/μl; 78.7% had an HIV-1 viral load <1000 copies/ml and 88% were on antiretroviral therapy. The percentage of patients harboring genotype 4 and with a higher HCV viral load was greater in the HIV-coinfected group. HCV/HIV-coinfected patients had more advanced liver fibrosis (Knodell fibrosis stages 3 + 4) than HCV-monoinfected patients (46.7% vs. 12%, p < 0.0001). In the univariate analysis, the factors associated with advanced liver disease were male sex (OR: 2.7, 95% CI: 1.05-7.1), history of injecting drug use (OR: 4.6, 95% CI: 2.0-10.2), HIV infection (OR: 6.4, 95% CI: 2.7-14.7), and previous exposure to therapy with protease inhibitors (OR: 3.0, 95% CI:1.4-6.3). In the multivariate analysis; only male sex (OR: 3.17, 95% CI: 1.152-8.773) and HIV infection (OR: 6.85, 95% CI: 2.93-16.005) were associated with advanced liver fibrosis. HIV infection is associated with advanced liver fibrosis. HIV/HCV-coinfected individuals on HAART are at risk of developing end-stage liver disease despite virological success and immunological reconstitution.
Original languageEnglish
Pages (from-to)1293-1297
JournalAIDS Research and Human Retroviruses
Volume20
Issue number12
DOIs
Publication statusPublished - 1 Jan 2004

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    Fuster, D., Planas, R., Muga, R., Ballesteros, A. L., Santos, J., Tor, J., Sirera, G., Guardiola, H., Salas, A., Cabré, E., Ojanguren, I., Barluenga, E., Rey-Joly, C., Clotet, B., & Tural, C. (2004). Advanced liver fibrosis in HIV/HCV-coinfected patients on antiretroviral therapy. AIDS Research and Human Retroviruses, 20(12), 1293-1297. https://doi.org/10.1089/aid.2004.20.1293