title: Evaluating Liver Fibrosis by Transient Elastometry in Patients With HIV-HCV Coinfection and Monoinfection.
abstract: BACKGROUND
  Due to the high efficacy of combination antiretroviral therapy (cART), the number of patients living with HIV is increasing. Chronic HCV infection has become a leading cause of non-AIDS related morbidity and mortality in patients with HIV infection.
  
  
  OBJECTIVE
  The aim of this cross-sectional study was to identify factors associated with liver fibrosis (LF) in patients with HIV monoinfection and HIV-HCV coinfection.
  
  
  METHODS
  We analyzed LF by transient elastometry ([TE], Fibroscan) in three groups of patients (HIV, HIV-HCV and HCV) followed at the Infectious Diseases Department of University of Ancona, Italy, between October 2009 and November 2012.
  
  
  RESULTS
  In total, 354 adults including 98 HIV, 70 HIV-HCV and 186 HCV patients were studied. HIV-HCV patients had a longer duration of HIV (P < 0.006) and HCV (P < 0.001) infections. Additionally, they were receiving cART therapy for a longer period (P < 0.001); they had higher prevalence of lipodystrophy (P < 0.001) and higher HCV load (P = 0.004). LF was significantly more pronounced in HCV and HIV-HCV compared to HIV patients (P < 0.001). A total of 13.3%, 39.2% and 51.4% of HIV, HCV and HIV-HCV, respectively, showed a LF ≥ F2. Additionally, a severe LF (F = 4) was significantly more frequent among HIV-HCV compared to other groups. A longer exposure to didanosine, stavudine, lopinavir/ritonavir and fosamprenavir resulted in increased LF by univariate analysis (P ranging from < 0.001 to 0.007). By logistic regression analysis, the only variables significantly associated with increased LF were HCV coinfection, older age, and high AST values (P ranging from < 0.001 to 0.036).
  
  
  CONCLUSIONS
  HCV coinfection, older age and AST were associated with LF in patients with HIV infection.
authors.affiliation: Department of Biomedical Sciences and Public Health, Clinical Infectious Diseases, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Brescini
authors.affiliation: Department of Biomedical Sciences and Public Health, Clinical Infectious Diseases, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Orsetti
authors.affiliation: Centre for Epidemiology and Biostatistics, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Rosaria
authors.initials: R
authors.lastname: Gesuita
authors.affiliation: Centre for Epidemiology and Biostatistics, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Piraccini
authors.affiliation: Department of Biomedical Sciences and Public Health, Clinical Infectious Diseases, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Marchionni
authors.affiliation: Department of Biomedical Sciences and Public Health, Clinical Infectious Diseases, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Staffolani
authors.affiliation: Department of Biomedical Sciences and Public Health, Clinical Infectious Diseases, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Pamela
authors.initials: P
authors.lastname: Castelli
authors.affiliation: Department of Biomedical Sciences and Public Health, Clinical Infectious Diseases, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Drenaggi
authors.affiliation: Department of Biomedical Sciences and Public Health, Clinical Infectious Diseases, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Barchiesi
keywords: Coinfection; Liver Fibrosis; Transient Elastometry