Similar progression of fibrosis between HIV/HCV co–infected and HCV–infected patients

Similar progression of fibrosis between HIV/HCV co–infected and HCV–infected patients

The latest Clinical Gastroenterology & Hepatology compares biopsy samples of HIV/HCV-infected and HCV-infected patients to investigate fibrosis progression.

Fibrosis progression might be accelerated in patients who are coinfected with human immunodeficiency virus (HIV) and HCV (HIV/HCV).

However, no studies have directly compared fibrosis progression by paired liver biopsy between patients infected with HIV and HCV versus those infected with only HCV.
Dr Richard Sterling and colleagues from Virginia, USA collected liver biopsy samples from patients with HIV/HCV, and those with HCV.

The research team compared biopsies from 59 without a sustained virologic response (SVR) or cirrhosis with control patients with only HCV.

The patients were matched for initial fibrosis stage, demographics, and HCV treatment.
Fibrosis remained unchanged in 55% with HIV/HCV at first biopsy
Clinical Gastroenterology & Hepatology

For HIV/HCV patients, categorical variables at baseline and the area under the curve of continuous variables per unit time were analyzed for associations with fibrosis progression.
The researchers observed that liver biopsies from HIV/HCV patients had more piecemeal necrosis than controls, and increased lobular inflammation.

HIV/HCV patients also had shorter intervals between liver biopsies.
Between the first and second biopsies, fibrosis remained unchanged or progressed 1 or 2 units in 55%, 18%, and 18% of HIV/HCV patients, respectively, compared with 45%, 30%, and 9% of controls.

The research team observed that the fibrosis progression rate was similar between HIV/HCV and control patients.

In paired biopsies from 66 patients, including those with sustained virological response, there were no associations between fibrosis progression and demographics.

The team found no association between fibrosis progression and numbers of CD4+ T cells, levels of aspartate aminotransferase or alanine aminotransferase, use of highly active antiretroviral therapy, response to HCV therapy, baseline levels of FIB-4, or inflammation, fibrosis, or steatosis.

Dr Sterling's team commented, "On the basis of analysis of liver biopsy samples, fibrosis progression was similar between HIV/HCV-infected and HCV-infected patients; no clinical or laboratory parameters predicted disease progression."
Clin Gastroenterol & Hepatol 2010: 8(12): 1070-76

20 December 2010