Liver fibrosis stage and HCV genotype distribution in HIV-HCV coinfected patients with persistently normal transaminases.
Hepatitis C virus (HCV)-infected patients with normal transaminases may show significant liver damage. The proportion of subjects with alanine aminotransferase (ALT) levels within normal limits was examined in HIV-infected patients never exposed to interferon and with detectable plasma HCV-RNA on regular follow-up at one single institution. Liver fibrosis was evaluated using transient elastography (FibroScan). Out of 281 coinfected patients, 25 (8.9%) had persistently normal ALT levels. Patients with HCV genotypes 2 (1/5; 20%) and 4 (10/50; 20%), more often had significantly normal ALT than patients with HCV-1 (13/158; 8%) (p = 0.01) and HCV-3 (1/49; 2%) (p = 0.01). Liver fibrosis stages in these patients were as follows: F0-F1 in 13 (59.1%), F2 in 4 (18.2%), F3 in 2 (9.1%), and F4 in 3 (13.6%). Advanced liver fibrosis (F3-F4) tended to be more frequent in patients infected with HCV-4 than HCV-1 (33.3% versus 9.1%; p = 0.2). Of HIV-infected patients with chronic hepatitis C 8.9% show persistently normal ALT levels. Nearly 25% of HIV-HCV-coinfected patients with persistently normal ALT show advanced liver fibrosis. Therefore, HCV-HIV-coinfected patients with normal ALT levels should be closely monitored.
Maida
Ivana
I
Service of Infectious Diseases, Hospital Carlos III, Madrid, Spain.
Soriano
Vincent
V
Barreiro
Pablo
P
Rivas
Pablo
P
Labarga
Pablo
P
Núñez
Marina
M
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D015658:HIV Infections / Q000150:complications* / Q000201:enzymology; D016174:Hepacivirus / Q000145:classification / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000201:enzymology / Q000235:genetics; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology* / Q000821:virology; D008297:Male; D012367:RNA, Viral / Q000097:blood
D012367:RNA, Viral; D000410:Alanine Transaminase