Contributions to hepatic fibrosis in HIV-HCV coinfected and HCV monoinfected patients.
OBJECTIVE
The aim of this study was to further explore the severity of liver disease and its predictors in a cohort of hepatitis C virus (HCV) infected patients, some of whom were coinfected with the human immunodeficiency virus (HIV).


METHODS
This is a retrospective, cross-sectional study of patients undergoing liver biopsy to stage HCV disease prior to consideration of anti-HCV therapy.


RESULTS
A total of 92 HIV-HCV coinfected and 372 HCV monoinfected patients were included. As might be expected, coinfected patients differed from monoinfected patients in a number of ways, including having lower body mass index (BMI), and lower alcohol intake. Liver disease was very similar between the two groups, with mean fibrosis score of 1.45 u for coinfected and 1.53 u for monoinfected (p = NS). Histological inflammation score dominated multivariate models of fibrosis when it was included in them. When only clinical predictors were used in multivariate models, BMI and type 2 diabetes had independent associations in monoinfected patients, whereas low CD4 count, current or nadir, was the only variable with an independent association in coinfected patients.


CONCLUSIONS
Coinfected patients do not have uniformly worse liver disease than monoinfected patients. Immune compromise plays an important role in liver disease in coinfected patients, and the role of other clinical factors in liver disease may differ between these two groups, as well.
Monto
Alexander
A
Gastroenterology Section, Veterans Affairs Medical Center, San Francisco, California 94121, USA.
Kakar
Sanjay
S
Dove
Lorna M
LM
Bostrom
Alan
A
Miller
Erica L
EL
Wright
Teresa L
TL
D001706:Biopsy; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005355:Fibrosis / Q000473:pathology; D015658:HIV Infections / Q000150:complications* / Q000473:pathology; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000473:pathology; D006801:Humans; D016014:Linear Models; D008107:Liver Diseases / Q000821:virology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric