Progression of chronic hepatitis C to liver fibrosis and cirrhosis in patients coinfected with hepatitis C virus and human immunodeficiency virus.
To evaluate the factors associated with the evolution of chronic hepatitis C in human immunodeficiency virus (HIV)-infected patients, a cross-sectional analysis of 41 HIV-infected patients with chronic hepatitis C (known as "HIV-HCV [hepatitis C virus]-coinfected patients") and a control group of patients with chronic hepatitis C who did not have HIV infection (known as "non-HIV-infected patients") was performed. The association of histological variables with demographic parameters, HCV load and genotype, HIV load, CD4(+) T cell count, and response to highly active antiretroviral therapy (HAART) was evaluated. HIV-HCV-coinfected patients showed a significantly higher HCV load, more-advanced fibrosis, and a higher liver fibrosis progression rate (FPR) than did non-HIV-infected patients. A high HCV load and a low CD4(+) T cell count were associated with a higher FPR. The immune response induced by HAART did not influence this progression. In conclusion, HIV-HCV-infected patients, mainly such patients with a high HCV load and an immunodepressed state, have a higher FPR. An independent effect of the immune response to HAART was not evident.
Martinez-Sierra
Carmen
C
Gastroenterology Unit, Hospital Universitario Puerta del Mar, Cádiz, Spain.
Arizcorreta
Ana
A
Díaz
Fernando
F
Roldán
Rafael
R
Martín-Herrera
Leopoldo
L
Pérez-Guzmán
Eugenio
E
Girón-González
José A
JA
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D018450:Disease Progression; D005260:Female; D005355:Fibrosis / Q000209:etiology*; D006678:HIV; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000473:pathology; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged