HIV coinfection does not compromise liver histological response to interferon therapy in patients with chronic hepatitis C.
OBJECTIVE
Although discrepancies between histological and virological responses to anti-hepatitis C virus (HCV) therapy are well-established in HIV-negative patients, the liver histological outcome has never been assessed in HIV-HCV co-infected patients receiving anti-HCV therapy. We compared histological responses to interferon (IFN) alpha therapy between HIV-positive and HIV-negative injecting drug users (IDU) and determined factors associated with histological response.


METHODS
Retrospective cohort study.


METHODS
Hepatology unit of a tertiary referral hospital.


METHODS
Seventy-nine HCV-infected IDU (32 HIV-positive) receiving a 6-month course of IFN-alpha2b therapy, 3 x 106 U three times a week.


METHODS
Histological response, defined by a > or =2 point decrease in total Knodell score measured on paired liver biopsies over a 2-year follow-up period.


RESULTS
The sustained response rate to IFN therapy was lower in HIV-positive patients than in HIV-negative patients (6.2% versus 29.8%;P = 0.012). Conversely, the rates of histological response (40.6% versus 36.2%) were not different between HIV-positive and HIV-negative patients. Independent factors associated with histological response were first total Knodell score (P = 0.0007) and sustained response to IFN therapy (odds ratio, 12.34; P = 0.005). Histological response was observed in 25% of IFN non-responders whatever their HIV status. In HIV-positive patients, the CD4 cell count did not influence the histological response.


CONCLUSIONS
in HIV-HCV co-infected patients treated with IFN, liver histological improvement is frequently observed, similarly to that observed in HIV-negative patients. Such beneficial effect of interferon therapy supports early treatment of chronic hepatitis C in HIV-infected patients.
Di Martino
Vincent
V
Service d'Hépatologie, INSERM U481 et Centre de Recherche Claude Bernard sur les hépatites virales, 100 Bd du Général Leclerc, Hôpital Beaujon, 92110 Clichy, France.
Thevenot
Thierry
T
Boyer
Nathalie
N
Cazals-Hatem
Dominique
D
Degott
Claude
C
Valla
Dominique
D
Marcellin
Patrick
P
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008099:Liver / Q000473:pathology; D008297:Male; D011994:Recombinant Proteins; D012189:Retrospective Studies; D015819:Substance Abuse, Intravenous / Q000150:complications
D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D000410:Alanine Transaminase