title: Low-level liver enzyme elevations during HAART are not associated with liver fibrosis progression among HIV/HCV-coinfected patients.
abstract: 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.
authors.affiliation: Unidad de Enfermedades Infecciosas, Hospital Universitario de Valme, Seville, Spain.
authors.forename: Salvador
authors.initials: S
authors.lastname: Vergara
authors.forename: Juan
authors.initials: J
authors.lastname: Macías
authors.forename: José A
authors.initials: JA
authors.lastname: Mira
authors.forename: José A
authors.initials: JA
authors.lastname: García-García
authors.forename: Nicolás
authors.initials: N
authors.lastname: Merchante
authors.forename: José
authors.initials: J
authors.lastname: del Valle
authors.forename: Laila
authors.initials: L
authors.lastname: Abdel-Kader
authors.forename: Fernando
authors.initials: F
authors.lastname: Lozano
authors.forename: Jesús M
authors.initials: JM
authors.lastname: Gómez-Mateos
authors.forename: Juan A
authors.initials: JA
authors.lastname: Pineda
mesh_terms: 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
chemical_list: D000410:Alanine Transaminase