Slower fibrosis progression in HIV/HCV-coinfected patients with successful HIV suppression using antiretroviral therapy.
Enviado por Jose F Rodriguez-Orengo el
Título | Slower fibrosis progression in HIV/HCV-coinfected patients with successful HIV suppression using antiretroviral therapy. |
Publication Type | Journal Article |
Year of Publication | 2006 |
Autores | Bräu, N, Salvatore, M, Ríos-Bedoya, CF, Fernández-Carbia, A, Paronetto, F, Rodríguez-Orengo, JF, Rodríguez-Torres, M |
Journal | J Hepatol |
Volume | 44 |
Issue | 1 |
Pagination | 47-55 |
Date Published | 2006 Jan |
ISSN | 0168-8278 |
Palabras clave | Adolescent, Adult, Aged, AIDS-Related Opportunistic Infections, Anti-Retroviral Agents, Antiretroviral Therapy, Highly Active, Biopsy, Disease Progression, Female, Follow-Up Studies, Hepatitis C, HIV, Humans, Liver, Liver Cirrhosis, Male, Middle Aged, Retrospective Studies, RNA, Viral, Treatment Outcome, Viral Load |
Abstract | BACKGROUND/AIMS: HIV/HCV-coinfected patients reportedly have a faster fibrosis progression rate (FPR) than HCV-monoinfected patients. This study examined whether HIV suppression through highly active antiretroviral therapy (HAART) attenuates this accelerated fibrosis progression. METHODS: In two hepatitis C centers, a retrospective analysis identified 656 consecutive treatment-naïve HCV-infected patients who had undergone a liver biopsy, had a presumed date of HCV infection, and had been tested for HIV, 274 of them HIV-positive (95.2% on HAART) and 382 HIV-negative. The primary outcome measure was the FPR, defined as Ishak fibrosis score [0-6] over estimated duration of HCV infection. RESULTS: Among HIV/HCV-coinfected patients, 51.2% had undetectable HIV RNA (< 400 copies/mL). There was no difference in FPR between HIV/HCV-coinfected and HCV-monoinfected patients (0.136 vs. 0.128 Ishak fibrosis units/year, P=0.29). However, HIV/HCV-coinfected patients with any detectable HIV viral load >400 copies/mL had a faster FPR (0.151) than HCV-monoinfected patients (0.128, P=0.015) and than HIV/HCV-coinfected patients with undetectable plasma HIV RNA (0.122, P=0.013) who in turn had the same FPR as HCV-monoinfected subjects (0.128, P=0.52). An accelerated FPR in HIV viremic patients was seen with CD4+ cells <500/mm(3) (0.162 vs. 0.123, undetectable HIV RNA, P=0.005) but not with CD4+ cells >500/mm(3) (0.118 vs. 0.121, P=0.89). In multivariable linear regression analysis of HIV/HCV-coinfected patients, log(10) HIV RNA level, necroinflammation, and age at HCV infection were independently correlated to FPR, but not alcohol use or CD4+ cell count (r(2)=0.45 for model). CONCLUSIONS: HIV/HCV-coinfected patients with undetectable HIV RNA through HAART have a slower FPR than those with any HIV RNA level and an FPR similar to HCV-monoinfected individuals. |
DOI | 10.1016/j.jhep.2005.07.006 |
Alternate Journal | J. Hepatol. |
PubMed ID | 16182404 |
Grant List | 1P20 RR 11126 / RR / NCRR NIH HHS / United States G12 RR 03051 / RR / NCRR NIH HHS / United States R01 AI 14941 / AI / NIAID NIH HHS / United States |