title: Insulin resistance is not associated with liver fibrosis progression in HIV/hepatitis C virus-coinfected patients.
abstract: Insulin resistance (IR) is a common condition in chronic hepatitis C. Recent studies have reported that IR is associated with liver fibrosis progression in these patients. However, there is no information available on this issue in human immunodeficiency virus (HIV)/hepatitis C virus (HCV)-coinfected patients. For these reasons, we investigate the relationship between IR and liver fibrosis in patients with HIV and HCV infections. This was a cross-sectional study where patients from an Infectious Diseases Unit with HIV/HCV coinfection who underwent a liver biopsy, with available frozen sera samples at the time of biopsy and a known or estimated date of infection were included. IR was determined by the homeostasis model assessment (HOMA-IR) method. The relationship between histological findings and several variables, including HOMA-IR values, was examined. Seventy-nine patients fulfilled the inclusion criteria. Age at HCV infection >21 years was the only variable independently associated with advanced liver fibrosis (stages F3 and F4) [adjusted odds ratio (AOR) 4.15; 95% confidence interval (CI) 1.5-11.3]. The variables associated with a fibrosis progression rate above the median were age at HCV infection >21 years (AOR 6.41; 95% CI 2.16-27.96) and previous exposure to nevirapine (AOR 8.9; 95% CI 2.01-39.36). There was no association between HOMA-IR values and the presence of advanced fibrosis or a faster fibrosis progression. Thus IR is not associated with liver damage or fibrosis progression in HIV/HCV-coinfected individuals.
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario de Valme, Sevilla, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Merchante
authors.forename: J
authors.initials: J
authors.lastname: Macías
authors.forename: E
authors.initials: E
authors.lastname: Ramayo
authors.forename: S
authors.initials: S
authors.lastname: Vergara
authors.forename: J A
authors.initials: JA
authors.lastname: García-García
authors.forename: J A
authors.initials: JA
authors.lastname: Mira
authors.forename: J E
authors.initials: JE
authors.lastname: Corzo
authors.forename: J M
authors.initials: JM
authors.lastname: Gómez-Mateos
authors.forename: F
authors.initials: F
authors.lastname: Lozano
authors.forename: J A
authors.initials: JA
authors.lastname: Pineda
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000150:complications / Q000378:metabolism* / Q000473:pathology / Q000821:virology; D006526:Hepatitis C / Q000150:complications / Q000378:metabolism* / Q000473:pathology / Q000821:virology; D006801:Humans; D007333:Insulin Resistance; D008103:Liver Cirrhosis / Q000378:metabolism* / Q000473:pathology / Q000821:virology; D008297:Male