Low-level liver enzyme elevations during HAART are not associated with liver fibrosis progression among HIV/HCV-coinfected patients.
OBJECTIVE
To assess the association between non-severe liver enzyme elevations (LEEs) during antiretroviral treatment and liver fibrosis in HIV/HCV-coinfected patients.


METHODS
All co-infected patients from an Infectious Disease Unit who had received treatment with highly active antiretroviral therapy (HAART) for at least 12 months before undergoing a liver biopsy were included in the study.


RESULTS
One-hundred and sixteen patients met the inclusion criteria of the study. Advanced liver fibrosis was observed in 32 (38%) of 84 patients who developed non-severe LEEs and in 11 (34%) of 32 subjects who developed severe (grade > or = 3) LEEs, (P = 0.7). Seven (6%) of 116 patients showed grade 3 or 4 LEEs for at least 30% of the follow-up. Advanced liver fibrosis was observed in five (71%) of these patients and in 38 (35%) of the 109 subjects who did not develop long-term severe LEEs (P = 0.05). Eight (10%) of 84 patients showed grade 2 LEEs for at least 30% of the follow-up. Advanced liver fibrosis was observed in 28 (37%) of 76 subjects who did not develop long-term grade 2 LEEs and in three (38%) of eight patients who developed them (P = 0.9).


CONCLUSIONS
In HIV/HCV-coinfected patients, non-severe LEEs, whether persistent or not, are not associated with advanced liver fibrosis. On the other hand, long-term severe LEEs are associated with more severe liver fibrosis in this population.
Vergara
Salvador
S
Unidad de Enfermedades Infecciosas, Hospital Universitario de Valme, Seville, Spain.
Macías
Juan
J
Mira
José A
JA
García-García
José A
JA
Merchante
Nicolás
N
del Valle
José
J
Abdel-Kader
Laila
L
Lozano
Fernando
F
Gómez-Mateos
Jesús M
JM
Pineda
Juan A
JA
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood*; D023241:Antiretroviral Therapy, Highly Active; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000201:enzymology; D006526:Hepatitis C / Q000150:complications* / Q000201:enzymology; D006801:Humans; D008103:Liver Cirrhosis / Q000201:enzymology / Q000209:etiology*; D008297:Male; D012189:Retrospective Studies
D000410:Alanine Transaminase