Impact of antiretroviral treatment on progression of hepatic fibrosis in HIV/hepatitis C virus co-infected patients.
BACKGROUND
The impact of immune reconstitution on liver fibrosis in HIV/hepatitis C virus (HCV) patients is unknown. In this case-control study, we investigated the impact of HIV infection on the severity of liver fibrosis and identified related factors.


METHODS
We studied 116 HIV/HCV patients and 235 HCV only patients all untreated for HCV. Each co-infected patient was matched with two singly-infected patients according to gender, age at contamination and duration of infection. Liver biopsy was analysed using the METAVIR score.


RESULTS
Alcohol consumption and route of contamination differed between HCV-infected and HCV/HIV co-infected patients. Among co-infected patients, a F3-F4 Metavir score was significantly more frequent than in mono-infected patients. Co-infected patients with severe fibrosis (F3-F4) had higher transaminase, ferritin levels and lower CD4 T-cell count than patients with none to moderate fibrosis (F0-F2). Although median duration of treatment with nucleoside analogues, non-nucleoside analogues and protease inhibitors were comparable in both groups, the delay between the presumed date of contamination and treatment initiation with highly active antiretroviral therapy (HAART) was significantly longer for patients with severe fibrosis than those with none to moderate fibrosis. Finally, the mean rate of fibrosis progression was significantly slower among patients exposed to HAART.


CONCLUSIONS
Early antiretroviral therapy in co-infected HIV-HCV patients may slow liver fibrosis progression.
Mariné-Barjoan
Eugènia
E
Service d'Hépato-gastroentérologie, CHU Nice, Hôpital de l'Archet, France. marine-barjoan.e@chu-nice.fr
Saint-Paul
Marie-Christine
MC
Pradier
Christian
C
Chaillou
Sylvie
S
Anty
Rodolphe
R
Michiels
Jean-François
JF
Sattonnet
Christophe
C
Ouzan
Denis
D
Dellamonica
Pierre
P
Tran
Albert
A
D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000473:pathology / Q000821:virology*; D006526:Hepatitis C / Q000473:pathology / Q000821:virology*; D006801:Humans; D008099:Liver / Q000473:pathology / Q000821:virology; D008103:Liver Cirrhosis / Q000473:pathology / Q000821:virology*; D008297:Male; D012044:Regression Analysis
D019380:Anti-HIV Agents