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Liver fibrosis progression in human immunodeficiency virus and hepatitis C virus coinfected patients

  1. Yves Benhamou M.D.1,*,
  2. Marie Bochet2,
  3. Vincent Di Martino1,
  4. Frederic Charlotte3,
  5. Felipe Azria1,
  6. Anne Coutellier4,
  7. Michel Vidaud1,
  8. François Bricaire2,
  9. Pierre Opolon1,
  10. Christine Katlama2,
  11. Thierry Poynard1

Article first published online: 30 DEC 2003

DOI: 10.1002/hep.510300409

Issue

Hepatology

Hepatology

Volume 30, Issue 4, pages 1054–1058, October 1999

Additional Information

How to Cite

Benhamou, Y., Bochet, M., Di Martino, V., Charlotte, F., Azria, F., Coutellier, A., Vidaud, M., Bricaire, F., Opolon, P., Katlama, C. and Poynard, T. (1999), Liver fibrosis progression in human immunodeficiency virus and hepatitis C virus coinfected patients. Hepatology, 30: 1054–1058. doi: 10.1002/hep.510300409

Author Information

  1. 1

    Service d'Hépato-Gastroentérologie, Groupe Hospitalier Pitié Salpêtrière and UPRES-A 8067, Paris, France

  2. 2

    Service de Maladies Infectieuses, Groupe Hospitalier Pitié-Salpêtrière, Paris, France

  3. 3

    Service d'Anatomie Pathologique, Groupe Hospitalier Pitié-Salpêtrière, Paris, France

  4. 4

    Service de Médecine Interne, Groupe Hospitalier Pitié-Salpêtrière, Paris, France

*Service d'Hépato Gastroentérologie, Groupe Hospitalier Pitié-Salpêtrière, 47 Boulevard de l'Hôpital, 75651 Paris Cedex 13, France. fax: (33) 1 45 86 20 22

Publication History

  1. Issue published online: 30 DEC 2003
  2. Article first published online: 30 DEC 2003
  3. Manuscript Accepted: 12 JUL 1999
  4. Manuscript Received: 14 MAY 1999

Funded by

  • Association pour la Recherche sur le Cancer
  • Assistance Publique des Hôpitaux de Paris
  • Agence Nationale pour la Recherche sur le Sida

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Abstract

The natural history of hepatitis C virus (HCV) infection in human immunodeficiency virus (HIV)-infected patients has never been studied according to the concept of liver fibrosis progression. The aim of this work was to assess the fibrosis progression rate in HIV-HCV coinfected patients and in patients infected by HCV only. A cohort of 122 HIV-HCV coinfected patients was compared with a control group of 122 HIV-negative HCV-infected patients. Groups were matched according to age, sex, daily alcohol consumption, age at HCV infection, and duration and route of HCV infection. The fibrosis progression rate was defined as the ratio between fibrosis stage (METAVIR scoring system) and the HCV duration. The prevalence of extensive liver fibrosis (METAVIR fibrosis scores 2, 3, and 4) and moderate or severe activity were higher in HIV-infected patients (60% and 54%, respectively) than in control patients (47% and 30%, respectively; P < .05 and P < .001, respectively). The median fibrosis progression rate in coinfected patients and in control patients was 0.153 (95% confidence interval [CI], 0.117-0.181) and 0.106 (95% CI, 0.084-0.125) fibrosis units per year, respectively (P < .0001). HIV seropositivity (P < .0001), alcohol consumption (>50 g/d, P = .0002), age at HCV infection (<25 years old,P< .0001), and severe immunosuppression (CD4 count ≤200 cells/μL,P< .0001) were associated with an increase in the fibrosis progression rate. In coinfected patients, alcohol consumption (>50 g/d), CD4 count (≤200 cells/μL), and age at HCV infection (<25 years old) (P< .0001, respectively) were associated with a higher fibrosis progression rate. HIV seropositivity accelerates HCV-related liver fibrosis progression. In coinfected patients, a low CD4 count, alcohol consumption rate, and age at HCV infection are associated with a higher liver fibrosis progression rate.

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