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and Hepatitis.com Coverage of the
17th Conference on Retroviruses and
Opportunistic Infections (CROI 2010)
February 16 - 19, San Franciso, California
More Evidence of Rapid Liver Disease Progression in HIV/HCV Coinfected People, but Antiretroviral Therapy Lowers Risk
has shown that liver disease typically progresses more rapidly in HIV/HCV
coinfected people compared to those with hepatitis
C alone, but studies may not be directly comparable and data have
not always been consistent.
fibrosis progression has been observed in studies of HIV/HCV coinfected
patients using serial liver biopsies, the researchers explained as background.
But because they are invasive, expensive, and uncomfortable, sequential
biopsies are not routine, and individuals usually only receive them
if disease progression is suspected; thus, serial biopsy recipients
are likely not representative of the coinfected population as a whole.
In this prospective study, liver stiffness was measured at baseline with follow-up measurements at least every 12 months. Fibrosis stages were classified as follows:
included 441 HIV/HCV coinfected patients with follow-up values. Most
(80%) were men and the median age was 44 years. Almost all (97%) were
receiving combination ART during follow-up. At baseline, the median
CD4 count was 444 cells/mm3 and 74% had undetectable HIV viral load.
About three-quarters had hard-to-treat HCV genotypes 1 or 4, about 20%
had received previous anti-HCV therapy, about 6% also had hepatitis
B, and the median liver stiffness at baseline was 6.9 KPa.
on these findings, the researchers concluded, "Achievement of HIV
suppression and increase of CD4 cell counts with HAART is associated
with a lower risk of worsening of liver damage."