title: Incidence and predictors of severe liver fibrosis in human immunodeficiency virus-infected patients with chronic hepatitis C: a European collaborative study.
abstract: A study was performed in 10 European health care centers in which 914 patients coinfected with hepatitis C virus (HCV) and human immunodeficiency virus (HIV) who had elevated serum alanine aminotransferase (ALT) levels underwent liver biopsy during the period of 1992 through 2002. Overall, the METAVIR liver fibrosis stage was F0 in 10% of patients, F1 in 33%, F2 in 22%, F3 in 22%, and F4 in 13%. Predictors of severe liver fibrosis (METAVIR stage, F3 or F4) in multivariate analysis were age of >35 years (odds ratio [OR], 2.95; 95% confidence interval [CI], 2.08-4.18), alcohol consumption of >50 g/day (OR, 1.61; 95% CI, 1.1-2.35), and CD4+ T cell count of <500 cells/mm3 (OR, 1.43; 95% CI, 1.03-1.98). Forty-six percent of patients aged >40 years had severe liver fibrosis, compared with 15% of subjects aged <30 years. The use of antiretroviral therapy was not associated with the severity of liver fibrosis. In summary, severe liver fibrosis is frequently found in HCV-HIV-coinfected patients with elevated serum ALT levels, and its severity increases significantly with age. The rate of complications due to end-stage liver disease will inevitably increase in this population, for whom anti-HCV therapy should be considered a priority.
authors.affiliation: Hospital Carlos III, Madrid, Spain.
authors.forename: Luz
authors.initials: L
authors.lastname: Martín-Carbonero
authors.forename: Yves
authors.initials: Y
authors.lastname: Benhamou
authors.forename: Massimo
authors.initials: M
authors.lastname: Puoti
authors.forename: Juan
authors.initials: J
authors.lastname: Berenguer
authors.forename: José
authors.initials: J
authors.lastname: Mallolas
authors.forename: Carmen
authors.initials: C
authors.lastname: Quereda
authors.forename: Ana
authors.initials: A
authors.lastname: Arizcorreta
authors.forename: Antonio
authors.initials: A
authors.lastname: Gonzalez
authors.forename: Jurgen
authors.initials: J
authors.lastname: Rockstroh
authors.forename: Victor
authors.initials: V
authors.lastname: Asensi
authors.forename: Pilar
authors.initials: P
authors.lastname: Miralles
authors.forename: Montse
authors.initials: M
authors.lastname: Laguno
authors.forename: Leonor
authors.initials: L
authors.lastname: Moreno
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Girón
authors.forename: Martin
authors.initials: M
authors.lastname: Vogel
authors.forename: Javier
authors.initials: J
authors.lastname: García-Samaniego
authors.forename: Marina
authors.initials: M
authors.lastname: Nuñez
authors.forename: Miriam
authors.initials: M
authors.lastname: Romero
authors.forename: Santiago
authors.initials: S
authors.lastname: Moreno
authors.forename: Juan José
authors.initials: JJ
authors.lastname: de la Cruz
authors.forename: Vincent
authors.initials: V
authors.lastname: Soriano
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000378:metabolism; D018791:CD4 Lymphocyte Count; D051263:D-Alanine Transaminase; D018450:Disease Progression; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000150:complications* / Q000276:immunology; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000276:immunology; D006801:Humans; D015994:Incidence; D008103:Liver Cirrhosis / Q000201:enzymology / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology; D008297:Male; D015999:Multivariate Analysis
chemical_list: D000410:Alanine Transaminase; D051263:D-Alanine Transaminase