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Predictors of liver fibrosis in HIV-infected patients with chronic hepatitis C virus (HCV) infection: assessment using transient elastometry and the role of HCV genotype 3.
Clin Infect Dis. 2006 Apr 01; 42(7):1032-9.CI

Abstract

BACKGROUND

Liver fibrosis is accelerated in patients coinfected with hepatitis C virus (HCV) and human immunodeficiency virus (HIV). The reasons for this faster liver disease progression are unclear, although higher plasma HCV RNA levels and distinct HCV genotype distribution in this population, compared with in HCV-monoinfected subjects, could play a role.

METHODS

Liver fibrosis was assessed using elastometry in all consecutive HIV-infected patients with chronic hepatitis C who attended our institution (Hospital Carlos III, Madrid) during the past 12 months. Hepatic stiffness was measured in kiloPascal units (kPa) and was interpreted on the basis of Metavir score: no or mild fibrosis (score, F0-F1) when liver stiffness is < or =7.1 kPa, and fibrosis with septa or cirrhosis (F2-F4) when >7.1 kPa.

RESULTS

A total of 283 patients (71% were male; mean age, 42 years; 94% were injection drug users and 94% were receiving antiretrovirals; mean CD4 cell count, 554 cells/microL; 72% with plasma HIV RNA level of <50 copies/mL) were analyzed. The mean alanine aminotransferase level was 68 IU/L, and the mean plasma HCV RNA level was 5.9 log IU/mL. HCV genotype distribution was as follows: genotype 1, 60% of patients; genotype 2, 2%; genotype 3, 26%; and genotype 4, 12%. Overall, 164 (58%) of the patients had scores indicating advanced liver fibrosis (F2-F4), as determined using elastometry. In the univariate and multivariate analyses, respectively, a significant odds ratio (OR) for score F2-F4 was found for HCV genotype 3, compared with the other genotypes (OR, 1.9 [95% confidence interval {CI}, 1.1-3.4] vs. 4.3 [95% CI, 1.4-13.3]); for older age (OR, 1.1 [95% CI, 1.03-1.17] vs. 1.1 [95% CI, 1.01-1.25]); and for elevated alanine aminotransferase levels (OR, 1.02 [95% CI, 1.01-1.03] vs. 1.03 [95% CI, 1.01-1.04]). Although patients with HCV genotype 1 had higher mean serum HCV RNA levels than did those with HCV genotype 3 (6.1 log IU/mL vs. 5.7 log IU/mL; P=.01), patients with HCV genotype 3 tended to have F2-F4 scores more frequently than did those with HCV genotype 1 (69% vs. 58%; P = not significant).

CONCLUSIONS

HCV genotype 3, older age, and elevated alanine aminotransferase levels are independent predictors of advanced liver fibrosis in HCV-HIV-coinfected patients.

Authors+Show Affiliations

Department of Infectious Diseases, Hospital Carlos III, Madrid, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16511772

Citation

Barreiro, Pablo, et al. "Predictors of Liver Fibrosis in HIV-infected Patients With Chronic Hepatitis C Virus (HCV) Infection: Assessment Using Transient Elastometry and the Role of HCV Genotype 3." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 42, no. 7, 2006, pp. 1032-9.
Barreiro P, Martín-Carbonero L, Núñez M, et al. Predictors of liver fibrosis in HIV-infected patients with chronic hepatitis C virus (HCV) infection: assessment using transient elastometry and the role of HCV genotype 3. Clin Infect Dis. 2006;42(7):1032-9.
Barreiro, P., Martín-Carbonero, L., Núñez, M., Rivas, P., Morente, A., Simarro, N., Labarga, P., González-Lahoz, J., & Soriano, V. (2006). Predictors of liver fibrosis in HIV-infected patients with chronic hepatitis C virus (HCV) infection: assessment using transient elastometry and the role of HCV genotype 3. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 42(7), 1032-9.
Barreiro P, et al. Predictors of Liver Fibrosis in HIV-infected Patients With Chronic Hepatitis C Virus (HCV) Infection: Assessment Using Transient Elastometry and the Role of HCV Genotype 3. Clin Infect Dis. 2006 Apr 1;42(7):1032-9. PubMed PMID: 16511772.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of liver fibrosis in HIV-infected patients with chronic hepatitis C virus (HCV) infection: assessment using transient elastometry and the role of HCV genotype 3. AU - Barreiro,Pablo, AU - Martín-Carbonero,Luz, AU - Núñez,Marina, AU - Rivas,Pablo, AU - Morente,Adolfo, AU - Simarro,Nuria, AU - Labarga,Pablo, AU - González-Lahoz,Juan, AU - Soriano,Vincent, Y1 - 2006/02/21/ PY - 2005/10/29/received PY - 2005/12/07/accepted PY - 2006/3/3/pubmed PY - 2006/6/9/medline PY - 2006/3/3/entrez SP - 1032 EP - 9 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 42 IS - 7 N2 - BACKGROUND: Liver fibrosis is accelerated in patients coinfected with hepatitis C virus (HCV) and human immunodeficiency virus (HIV). The reasons for this faster liver disease progression are unclear, although higher plasma HCV RNA levels and distinct HCV genotype distribution in this population, compared with in HCV-monoinfected subjects, could play a role. METHODS: Liver fibrosis was assessed using elastometry in all consecutive HIV-infected patients with chronic hepatitis C who attended our institution (Hospital Carlos III, Madrid) during the past 12 months. Hepatic stiffness was measured in kiloPascal units (kPa) and was interpreted on the basis of Metavir score: no or mild fibrosis (score, F0-F1) when liver stiffness is < or =7.1 kPa, and fibrosis with septa or cirrhosis (F2-F4) when >7.1 kPa. RESULTS: A total of 283 patients (71% were male; mean age, 42 years; 94% were injection drug users and 94% were receiving antiretrovirals; mean CD4 cell count, 554 cells/microL; 72% with plasma HIV RNA level of <50 copies/mL) were analyzed. The mean alanine aminotransferase level was 68 IU/L, and the mean plasma HCV RNA level was 5.9 log IU/mL. HCV genotype distribution was as follows: genotype 1, 60% of patients; genotype 2, 2%; genotype 3, 26%; and genotype 4, 12%. Overall, 164 (58%) of the patients had scores indicating advanced liver fibrosis (F2-F4), as determined using elastometry. In the univariate and multivariate analyses, respectively, a significant odds ratio (OR) for score F2-F4 was found for HCV genotype 3, compared with the other genotypes (OR, 1.9 [95% confidence interval {CI}, 1.1-3.4] vs. 4.3 [95% CI, 1.4-13.3]); for older age (OR, 1.1 [95% CI, 1.03-1.17] vs. 1.1 [95% CI, 1.01-1.25]); and for elevated alanine aminotransferase levels (OR, 1.02 [95% CI, 1.01-1.03] vs. 1.03 [95% CI, 1.01-1.04]). Although patients with HCV genotype 1 had higher mean serum HCV RNA levels than did those with HCV genotype 3 (6.1 log IU/mL vs. 5.7 log IU/mL; P=.01), patients with HCV genotype 3 tended to have F2-F4 scores more frequently than did those with HCV genotype 1 (69% vs. 58%; P = not significant). CONCLUSIONS: HCV genotype 3, older age, and elevated alanine aminotransferase levels are independent predictors of advanced liver fibrosis in HCV-HIV-coinfected patients. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/16511772/Predictors_of_liver_fibrosis_in_HIV_infected_patients_with_chronic_hepatitis_C_virus__HCV__infection:_assessment_using_transient_elastometry_and_the_role_of_HCV_genotype_3_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/501021 DB - PRIME DP - Unbound Medicine ER -