Liver fibrosis on account of chronic hepatitis C is more severe in HIV-positive than HIV-negative patients despite antiretroviral therapy

  1. V. De Lédinghen1,2,
  2. P. Barreiro3,
  3. J. Foucher1,
  4. P. Labarga3,
  5. L. Castéra1,
  6. M. E. Vispo3,
  7. P.-H. Bernard4,
  8. L. Martin-Carbonero3,
  9. D. Neau5,
  10. P. García-Gascó3,
  11. W. Merrouche1,
  12. V. Soriano3

Article first published online: 22 JAN 2008

DOI: 10.1111/j.1365-2893.2007.00962.x

Issue

Journal of Viral Hepatitis

Journal of Viral Hepatitis

Volume 15, Issue 6, pages 427–433, June 2008

Additional Information

How to Cite

De Lédinghen, V., Barreiro, P., Foucher, J., Labarga, P., Castéra, L., Vispo, M. E., Bernard, P.-H., Martin-Carbonero, L., Neau, D., García-Gascó, P., Merrouche, W. and Soriano, V. (2008), Liver fibrosis on account of chronic hepatitis C is more severe in HIV-positive than HIV-negative patients despite antiretroviral therapy. Journal of Viral Hepatitis, 15: 427–433. doi: 10.1111/j.1365-2893.2007.00962.x

Author Information

  1. 1

    Centre d’Investigation de la Fibrose Hépatique, Hôpital Haut-Lévêque, CHU Bordeaux, Pessac, France

  2. 2

    INSERM, U889, Université Victor Segalen, Bordeaux, France

  3. 3

    Department of Infectious Diseases, Hospital Carlos III, Madrid, Spain

  4. 4

    Service d’Hépato-Gastroentérologie, Hôpital Saint-André, CHU Bordeaux, Bordeaux, France

  5. 5

    Service de Maladies Infectieuses, Hôpital Pellegrin, CHU Bordeaux, Bordeaux, France

*Pr. Victor de Lédinghen, Centre d’Investigation de la Fibrose Hépatique, Hôpital Haut-Lévêque, CHU Bordeaux, 33604 Pessac Cedex, France. E-mail: victor.deledinghen@chu-bordeaux.fr

Publication History

  1. Issue published online: 30 JAN 2008
  2. Article first published online: 22 JAN 2008
  3. Received July 2007; accepted for publication October 2007

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Keywords:

  • coinfection;
  • FibroScan;
  • hepatitis C;
  • HIV;
  • liver fibrosis;
  • transient elastography

Summary.  The recent availability of non-invasive tools to measure liver fibrosis has allowed examination of its extent and determination of predictors in all patients with chronic hepatitis C virus (HCV) infection. On the other hand, most information on hepatic fibrosis in HCV/human immunodeficiency virus (HIV)-coinfected patients has been derived from liver biopsies taken before highly active antiretroviral therapy (HAART) was widely available. All consecutive HCV patients with elevated aminotransferases seen during the last 3 years were evaluated and liver fibrosis measured using transient elastography (FibroScan®) and biochemical indexes. Patients were split according to their HIV serostatus. A total of 656 (69.6%) HCV-monoinfected and 287 (30.4%) HIV/HCV-coinfected patients were assessed. Mean CD4 count of coinfected patients was 493 cells/μL and 88% were under HAART (mean time, 4.2 ± 2.4 years). Advanced liver fibrosis or cirrhosis was recognized in 39% of the coinfected and 18% of the monoinfected patients (P < 0.005). A good correlation was found between FibroScan® and biochemical indexes [AST to platelet ratio index (r = 0.405, P < 0.0001), FIB-4 (r = 0.393, P < 0.0001) and Forns (r = 0.407, P < 0.0001)], regardless of the HIV status. In the multivariate analysis, age >45 years, body mass index (BMI) >25 kg/m2, and HIV infection were independently associated with advanced liver fibrosis or cirrhosis. HIV/HCV-coinfected patients have more advanced liver fibrosis than HCV-monoinfected patients despite the immunologic benefit of HAART.

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