title: The clinical spectrum of hepatitis C virus in HIV coinfection.
abstract: The biochemical, virologic, and histologic spectrum of hepatitis C virus (HCV) in 66 consecutive patients with HIV-HCV coinfection and 119 HCV controls was compared: 86% of coinfected patients had CD4 counts >200 cells/mm3, 51% had a normal alanine aminotransferase (ALT) value, the mean HCV RNA titer was 5.7 log IU/mL, 92% of coinfected patients were of genotype 1, and the mean histologic activity index was 6.86 with advanced fibrosis in 32% of patients. The biochemical, virologic, and histologic findings of HCV in coinfected patients were similar to those observed in HCV controls. For both groups of patients, no clinical, biochemical, or virologic factors could reliably identify patients with advanced fibrosis or cirrhosis, underscoring the importance of liver biopsy in the evaluation of these patients. The spectrum of liver disease in coinfection includes a significant proportion of patients with normal ALT values, and excluding these patients from previous studies has led to an overestimation of HCV disease severity.
authors.affiliation: Section of Hepatology, Virginia Commonwealth University Health System/Medical College of Virginia Hospitals, Richmond, Virginia, USA. rksterli@hsc.vcu.edu
authors.forename: Richard K
authors.initials: RK
authors.lastname: Sterling
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Contos
authors.forename: Arun J
authors.initials: AJ
authors.lastname: Sanyal
authors.forename: Velimir A
authors.initials: VA
authors.lastname: Luketic
authors.forename: R Todd
authors.initials: RT
authors.lastname: Stravitz
authors.forename: Mary S
authors.initials: MS
authors.lastname: Wilson
authors.forename: A Scott
authors.initials: AS
authors.lastname: Mills
authors.forename: Mitchell L
authors.initials: ML
authors.lastname: Shiffman
mesh_terms: D000328:Adult; D005260:Female; D006678:HIV / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology; D015658:HIV Infections / Q000150:complications* / Q000276:immunology; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology; D006526:Hepatitis C / Q000150:complications* / Q000276:immunology / Q000473:pathology* / Q000821:virology; D006801:Humans; D008099:Liver / Q000473:pathology / Q000821:virology; D008103:Liver Cirrhosis / Q000150:complications* / Q000276:immunology / Q000473:pathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral; D019562:Viral Load
chemical_list: D012367:RNA, Viral