HAART is associated with lower hepatic necroinflammatory activity in HIV-hepatitis C virus-coinfected patients with CD4 cell count of more than 350 cells/microl at the time of liver biopsy.
OBJECTIVE
To evaluate the impact of HAART on the liver damage of HIV-hepatitis C virus (HCV)-coinfected patients with relatively preserved immune status.


METHODS
Cross-sectional study of liver biopsies.


METHODS
HIV-HCV-coinfected patients who underwent liver biopsies and had a CD4 cell count of at least 350 cells/microl at the time of liver biopsy were included. Exclusion criteria included positive hepatitis B surface antigen and prior anti-HCV therapy. Necroinflammatory activity and fibrosis was scored by the Scheuer fibrosis staging system. Steatosis was scored according to the percentage of hepatocytes affected. Logistic regression analysis was used to assess determinants of necroinflammatory activity of at least 3.


RESULTS
One hundred and nineteen HIV-HCV coinfected patients were included. In the univariate analysis, alcohol abuse, serum alanine aminotransferase levels, steatosis and a high fibrosis score were significantly associated with higher necroinflammatory activity. In the multivariate analysis, a high level of alanine aminotransferase, advanced fibrosis and absence of HAART were associated with higher necroinflammatory activity.


CONCLUSIONS
Use of HAART was associated with lower levels of necroinflammatory activity. Necroinflammatory activity was strongly associated with higher fibrosis scores. These results suggest that HAART might decrease hepatitis C activity in HIV-HCV-coinfected patients with CD4 cell count of more than 350 cells/microl.
Pascual-Pareja
José F
JF
Servicio de Medicina Interna, Hospital La Paz, Paseo de la Castellana 261, Madrid 28046, Spain. jfpascualpareja@yahoo.es
Caminoa
Alejandra
A
Larrauri
Caminoa
C
González-García
Juan
J
Montes
Maria L
ML
Díez
Jesús
J
Grande
Marta
M
Arribas
José R
JR
D000328:Adult; D019380:Anti-HIV Agents / Q000494:pharmacology*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D005260:Female; D005355:Fibrosis; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000276:immunology*; D006526:Hepatitis C / Q000150:complications / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000187:drug effects / Q000473:pathology*; D008297:Male; D013030:Spain
D019380:Anti-HIV Agents