Transient elastography discloses identical distribution of liver fibrosis in chronic hepatitis C between HIV-negative and HIV-positive patients on HAART.
OBJECTIVE
Progressive immunodeficiency associated with HIV-infection leads to a progressive course of liver disease in HIV/HCV-co-infected patients. Highly active antiretroviral therapy (HAART) efficiently restores and preserves immune functions and has recently been demonstrated to also result in reduced liver-related mortality in HIV/HCV-co-infected patients.


METHODS
To analyse differences in current liver fibrosis as a possible effect of HAART on fibrosis progression we assessed hepatic fibrosis by transient elastography in a cross-sectional comparison between HCV-mono-infected and HIV/HCV-co-infected patients presenting at our outpatient department in 2007.


RESULTS
Overall, we did not find any difference in the distribution of liver stiffness between mono- (n = 84) and double-infected (n = 57) patients (14.4 kPa (10.8-18.2) versus 12.4 kPa (9.1 - 16.1), mean (95%-CI)). However, in the 8 HIV+ patients with CD4 counts < 200/microl liver stiffness was markedly greater (18.4 kPa (0.8 - 36.0)) than in HIV+ patients with preserved immunity (11.5 kPa (8.4-15.0)).


CONCLUSIONS
These findings are in line with other data that show an improved prognosis of chronic hepatitis C in HIV+ patients under effective HAART, and may be a hint that fibrosis progression in well-treated HIV+ patients will no longer be different from that in HCV-mono-infected patients.
Grünhage
F
F
Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany.
Wasmuth
J-C
JC
Herkenrath
S
S
Vidovic
N
N
Goldmann
G
G
Rockstroh
J
J
Lammert
F
F
Oldenburg
J
J
Sauerbruch
T
T
Spengler
Ulrich
U
D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018450:Disease Progression; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000150:complications / Q000188:drug therapy*; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000473:pathology*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index
D019380:Anti-HIV Agents