title: Time on antiretroviral therapy is a protective factor for liver fibrosis in HIV and hepatitis C virus (HCV) co-infected patients.
abstract: To assess the factors associated with liver fibrosis in human immunodeficiency virus and hepatitis C virus (HIV/HCV) co-infected patients eligible for anti-HCV therapy, we performed an observational, single-centred, cross-sectional study of 180 HIV/HCV co-infected patients who underwent liver biopsy between May 1998 and November 2001. A total of 126 patients with a known date of HCV infection were evaluated. Liver fibrosis was defined as a Knodell stage of fibrosis 1-4. The mean age was 36.7 (3.8) years, 81% were male and had a mean age of 20.5 (3.8) years at HCV infection. Mean CD4 cell count and plasma HIV-1 RNA load at the time of biopsy were 552 cell/mm3 (239) and 2.5 log10 (0.9), respectively; 118 patients had been on antiretroviral therapy (ART) for a median of 45 months (Q1-Q3: 21-75) and 84 on protease inhibitor for a median of 12.0 months (Q1-Q3: 0-29.5); 55 had an AIDS event or a CD4 cell count nadir < 200 cells/mm3 prior to biopsy. Median histological activity index was 6 and 27% had a Knodell stage of fibrosis 0. On the multivariate analysis time on ART (OR for 6 months extra: 0.954, 95% CI: 0.859-0.994), CD4 cell count at the time of liver biopsy (OR for 100 cells/mL increase: 0.740, 95% CI: 0.670-0.905), age at HCV infection acquisition (OR for 5 years extra: 2.594, 95% CI: 1.326-5.133) and alcohol intake (> 50 g/day) (OR: 2.73, 95% CI: 1.108-6.731) were associated with liver fibrosis. Hence ART should be a priority in HIV/HCV co-infected patients eligible for anti-HCV treatment as it is a protective factor for liver fibrosis.
authors.affiliation: Clinical HIV Unit, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain. ctural@ns.hugtip.scs.es
authors.forename: C
authors.initials: C
authors.lastname: Tural
authors.forename: D
authors.initials: D
authors.lastname: Fuster
authors.forename: J
authors.initials: J
authors.lastname: Tor
authors.forename: I
authors.initials: I
authors.lastname: Ojanguren
authors.forename: G
authors.initials: G
authors.lastname: Sirera
authors.forename: A
authors.initials: A
authors.lastname: Ballesteros
authors.forename: J A J
authors.initials: JA
authors.lastname: Lasanta
authors.forename: R
authors.initials: R
authors.lastname: Planas
authors.forename: C
authors.initials: C
authors.lastname: Rey-Joly
authors.forename: B
authors.initials: B
authors.lastname: Clotet
mesh_terms: D000328:Adult; D000367:Age Factors; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D001706:Biopsy; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D015497:HIV-1 / Q000254:growth & development*; D016174:Hepacivirus / Q000254:growth & development* / Q000378:metabolism; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008103:Liver Cirrhosis / Q000517:prevention & control* / Q000821:virology*; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D012367:RNA, Viral / Q000097:blood; D012737:Sex Factors; D019562:Viral Load
chemical_list: D044966:Anti-Retroviral Agents; D012367:RNA, Viral