HIV and Hepatitis.com Coverage of the
14th Annual Conference on Retroviruses
and Opportunistic Infections (14th CROI)
February 25 - 28, 2007, Los Angeles, CA
Steatosis in HIV-HCV Coinfected Patients Is Independently Associated with Advanced Liver Fibrosis and Genotype 3 HCV


HCV-related liver disease has become increasingly common in HIV positive individuals in the HAART era. However, there are limited data on the effect of steatosis (fatty liver) on HCV-related fibrosis progression in HIV-HCV coinfected patients.

The objective of the current study, presented at the 14th Conference on Retroviruses and Opportunistic Infections last month in Los Angeles, was to evaluate the impact of steatosis on HCV progression in 134 HIV-HCV coinfected patients at 3 medical centers in the UK and Ireland.

Three-quarters of the study participants were men, 33% had used HAART, and the median CD4 cell count at the time of biopsy was 326 cellsmm3. The main risk factor for HCV infection was injection drug use (75%).

The investigators reviewed epidemiological data, a single expert scored patients’ liver biopsies, and both univariate and multivariate analysis were performed to assess factors associated with steatosis. 

Results
  • A univariate analysis demonstrated a significant association between steatosis:
    • genotype 3 HCV (P = 0.005);
    • severe fibrosis (P = 0.03);
    • higher inflammatory grade (P = 0.03).

  • No significant association was observed with age, sex, time of HCV infection, duration of HCV infection, source of HCV infection, body mass index, alcohol intake, use of antiretroviral therapy, or HIV viral load.

  • A multivariate analysis confirmed the association between steatosis and severe liver disease (fibrosis stage 3 and 4) (P = 0.009) and genotype 3 HCV (P = 0.005). 
Conclusion

Based on these results, the investigators concluded, “Steatosis in HIV-HCV coinfected patients was independently associated with advanced liver fibrosis and genotype 3 disease. Factors that modify steatosis should be given more attention in this group with accelerated HCV disease progression.”

Chelsea and Westminster Hosp, London, UK; St James's Hospital, Dublin, Ireland; and Institute of Liver Studies, King's College Hospital, London, UK.

Link to study abstract

03/20/07

Reference
A Mohsen, D O'Shea, B Portmann, and others. Steatosis in HIV/HVC-co-infected Patients. 14th Conference on Retroviruses and Opportunistic Infections. Los Angeles, February 25-28, 2007. Abstract 926 (poster).











































14th croi