title: Influence of interferon-based therapy on liver fibrosis progression in HIV/HCV coinfected patients: a retrospective repeated liver biopsy analysis.
abstract: OBJECTIVE
  Hepatitis C virus (HCV) coinfection is one of the leading causes of mortality in human immunodeficiency virus-infected patients. The current standard of care leads to cure only in a part of these patients. The course of the disease is determined by the rapidity of liver fibrosis progression (LFP). The influence of interferon on LFP in coinfected patients has yet not been evaluated by comparative liver biopsies.
  
  
  METHODS
  We extracted data of patients who had serial liver biopsies from a hospital database. Histopathological findings were compared to factors possibly linked to fibrosis progression. Furthermore, we studied the impact of response to interferon treatment on fibrosis progression.
  
  
  RESULTS
  Hundred and twenty-six patients were included, 68 had received anti-HCV treatment, and 58 had not. The median time between the first and the last biopsy was 4 years. Worsened fibrosis was observed in 35 of 58 (60%) untreated patients, and 22 of 50 (44%) patients in the nonresponder/relapser group, and in 5 out of 18 (28%) in the SVR group. Liver fibrosis evolution was significantly better in patients achieving a SVR than in untreated and NR/R patients (p<0.02, odds-ratio [95% CI] for improvement vs. stability vs. worsening=3.16 [1.24-8.07]). This result persisted after adjustment for known predictors of liver fibrosis progression, HBsAg, CD4, and alcohol consumption: adjusted odds ratio=2.89 [1.09-7.68], p=0.03.
  
  
  CONCLUSIONS
  HCV treatment can stop fibrosis progression and induce its regression. Nonresponders to treatment may even have a fast fibrosis progression. It remains to be clarified if the same factors that induce nonresponse to treatment may also induce faster fibrosis progression.
authors.affiliation: Hepatology Department, Pitié-Salpêtrière Hospital, Paris, France. p_ingiliz@web.de
authors.forename: Patrick
authors.initials: P
authors.lastname: Ingiliz
authors.forename: Marc-Antoine
authors.initials: MA
authors.lastname: Valantin
authors.forename: Paul
authors.initials: P
authors.lastname: Preziosi
authors.forename: Laetitia
authors.initials: L
authors.lastname: Finzi
authors.forename: Raluka
authors.initials: R
authors.lastname: Pais
authors.forename: Larysa
authors.initials: L
authors.lastname: Fedchuk
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Dominguez
authors.forename: Christine
authors.initials: C
authors.lastname: Katlama
authors.forename: Thierry
authors.initials: T
authors.lastname: Poynard
authors.forename: Yves
authors.initials: Y
authors.lastname: Benhamou
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001706:Biopsy; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha