[Factors associated with hepatic steatosis in human immunodeficiency virus and hepatits C virus coinfected patients].
OBJECTIVE
To determinate the prevalence and factors associated with hepatic steatosis and severity of steatosis in human immunodeficiency virus (HIV) and hepatits C virus (HCV) coinfected patients.


METHODS
Liver histology was assessed in 163 HIV-HCV coinfected patients. Exclusion criteria included positive hepatitis B surface antigen and prior anti-HCV therapy. Steatosis was scored by a single pathologist according to the percentage of affected hepatocytes. Necroinflammatory activity and fibrosis was scored by the Scheuer system. Logistic regression analyses were used to evaluate variables associated with hepatic steatosis.


RESULTS
Steatosis was present in 65% of biopsy samples. Moderate-severe steatosis (>30% of hepatocytes) was detected in 17% of patients. 78.5% of patients were under high active antiretroviral therapy at the time of biopsy. In a multivariate analysis, steatosis was associated with body weight, alcohol, advanced fibrosis, stavudine use and non-use of lopinavir/ritonavir. In a multivariate analysis, severity of steatosis (>30% of hepatocytes) was associated with alcohol, HCV genotype 3, HCV load >1,400,000 copies/ml and advanced fibrosis.


CONCLUSIONS
The presence of hepatic steatosis and severity of steatosis were associated with advanced fibrosis in patients coinfected with HIV and HCV. Body weight, consumption of alcohol and antiretroviral therapy (stavudine use and absence of exposure to lopinavir/ritonavir) were modifiable factors associated with the presence of steatosis. Characteristics of HCV infection were associated with the severity of steatosis in this population.
Pascual Pareja
José Francisco
JF
Servicio de Medicina Interna, Hospital Universitario de La Paz, Madrid, España. jfpascualpareja@yahoo.es
Camino
Alejandra
A
Larrauri
Javier
J
López-Diéguez
María
M
Montes
María Luisa
ML
González-García
Juan
J
Peña
José María
JM
Díez
Jesús
J
Arribas
José Ramón
JR
D000328:Adult; D001706:Biopsy; D005234:Fatty Liver / Q000453:epidemiology* / Q000209:etiology* / Q000473:pathology; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies