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- Title
Factors influencing liver fibrosis and necroinflammation in HIV/HCV coinfection and HCV monoinfection.
- Authors
Sagnelli, C.; Uberti-Foppa, C.; Pasquale, G.; Pascalis, S.; Coppola, N.; Albarello, L.; Doglioni, C.; Lazzarin, A.; Sagnelli, E.
- Abstract
Objectives: To define differences in liver histology between HIV/HCV coinfection and HCV monoinfection, and to investigate possible causative factors. Methods: Liver biopsies (LBs) from 440 consecutive HIV/HCV-coinfected patients (Group HIV/HCV) and 374 consecutive HCV-monoinfected patients (Group HCV) were evaluated for necroinflammation and fibrosis (Ishak) by a pathologist unaware of the clinical and laboratory data. All patients were HBsAg-negative, with no history of alcohol abuse and naïve to anti-HCV treatment. At LB, 78.4 % of patients in Group HIV/HCV were on an antiretroviral regimen. Results: HIV/HCV-coinfected patients compared to the HCV-monoinfected patients were younger ( p < 0.0001), more frequently males ( p < 0.0001), and had HCV genotype 3 ( p < 0.0001); they showed a good immunological condition (CD4+ cell count: 518 ± 166 cells/mm). Patients in Group HIV/HCV more frequently showed a fibrosis score ≥4 (27.5 vs. 20.6 %, p < 0.05) and a necroinflammation score ≥9 (25.9 vs. 13.4 %; p < 0.0001). The prevalence of patients with fibrosis score ≥4 was significantly higher in older age classes in both Group HIV/HCV ( p < 0.005) and Group HCV ( p < 0.05). A necroinflammation score ≥9 was significantly higher in older age classes only in Group HIV/HCV ( p < 0.05). A multivariate analysis for Group HIV/HCV revealed that the patient age and nadir of CD4+ cell count were independently associated to higher degrees of fibrosis, the patient age and antiretroviral treatment were associated to higher degrees of necroinflammation, and HCV genotype 3 was associated to higher degrees of steatosis. Conclusion: The data suggest a need for early anti-HCV treatment in both HCV-monoinfected and HIV/HCV-coinfected patients.
- Subjects
HEPATITIS C diagnosis; DIAGNOSIS of HIV infections; BIOPSY; HISTOLOGY methodology; CHI-squared test; ENZYME-linked immunosorbent assay; LIVER diseases; MULTIVARIATE analysis; NECROSIS; T-test (Statistics); U-statistics; COMORBIDITY; LOGISTIC regression analysis; FIBROSIS
- Publication
Infection, 2013, Vol 41, Issue 5, p959
- ISSN
0300-8126
- Publication type
Article
- DOI
10.1007/s15010-013-0502-3