HCV-Related
Liver Fibrosis Is More Severe in HIV Positive Individuals Despite Antiretroviral
Therapy
By
Liz Highleyman
Some
prior research indicates that HIV positive people
tend to experience more rapid progression of liver disease related to chronic
hepatitis C virus (HCV) infection and may experience more severe fibrosis.
However, data have been mixed, with some studies suggesting that coinfected
individuals - especially those with well-preserved immune function -- may
fare as well as HIV negative people.
In
the June 2008 Journal of Viral Hepatitis, French researchers reported results
from a study involving non-invasive assessment of liver fibrosis in HIV-HCV
coinfected patients.
As
background, the study authors noted that the recent availability of non-invasive
methods for measuring fibrosis, such as blood biomarker assays and novel imaging
techniques, has enabled assessment of the extent of fibrosis and determination
of predictive factors without the need for frequent repeat liver biopsies. However,
most information about fibrosis progression in HIV-HCV coinfected individuals
has been derived from liver
biopsies taken before highly active
antiretroviral therapy (HAART) became widely available.
The
present study included all consecutive hepatitis C patients with elevated aminotransferases
(ALT and AST) seen at the investigators' clinics during the past 3 years. Participants
were stratified according to HIV serostatus, with 656 (69.9%) being HIV negative
and 287 (30.4%) being HIV positive. Among the coinfected patients, the mean CD4
count was 493 cells/mm3 and 88% were on HAART (mean duration 4.2 years).
Liver
fibrosis was assessed using transient elastography (FibroScan) - which measures
liver stiffness in kiloPascals -- and biochemical indices.
Results
