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Risk factors for fibrosis progression in HIV/HCV coinfected patients from a retrospective analysis of liver biopsies in 1985-2002.
HIV Med. 2006 Jul; 7(5):331-7.HM

Abstract

OBJECTIVES

To identify predictive factors for moderate/severe liver fibrosis and to analyse fibrosis progression in paired liver biopsies from HIV-positive patients with chronic hepatitis C virus (HCV) infection.

METHODS

HIV/HCV coinfected patients followed at the 2nd Department of Infectious Diseases of L. Sacco Hospital in Milan, Italy, with at least one liver biopsy specimen were retrospectively evaluated.

RESULTS

A total of 110 patients were enrolled in the study. In a univariate analysis, predictive factors of Ishak-Knodell stage > or =3 were a history of alcohol abuse [odds ratio (OR) 3.6, P=0.004], alanine aminotransferase level >100 IU/L at biopsy (OR 2.4, P=0.05), necro-inflammatory grade > or =9 (OR 37.14, P<0.0001) and CD4 count <350 cells/microL at nadir (OR 5.3, P=0.05). In a multivariate analysis, age >35 years (OR 3.19, P=0.04) and alcohol abuse (OR 4.36, P=0.002) remained independently associated with Ishak-Knodell stage. Paired liver biopsies were available in 36 patients; 18 showed an increase of at least one stage in the subsequent liver biopsy. Either in a univariate or in a multivariate analysis, a decrease of CD4 cell count of more than 10% between two biopsies (OR 6.85, P=0.002) was significantly associated with liver fibrosis progression.

CONCLUSION

Our findings highlight the relevance of encouraging a withdrawal of alcohol consumption in people with chronic HCV infection and of carrying out close follow-up of patients, especially if they are more than 35 years old. It is therefore mandatory to evaluate HIV/HCV coinfected patients for anti-HCV treatment and to increase CD4 cell count through antiretroviral therapy in order to reduce the risk of fibrosis progression and to slow the evolution of liver disease.

Authors+Show Affiliations

2nd Department of Infectious Diseases, Sacco Hospital, Milan, Italy. inf2div@hsacco.itNo affiliation info availableNo 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

Language

eng

PubMed ID

16945079

Citation

Schiavini, M, et al. "Risk Factors for Fibrosis Progression in HIV/HCV Coinfected Patients From a Retrospective Analysis of Liver Biopsies in 1985-2002." HIV Medicine, vol. 7, no. 5, 2006, pp. 331-7.
Schiavini M, Angeli E, Mainini A, et al. Risk factors for fibrosis progression in HIV/HCV coinfected patients from a retrospective analysis of liver biopsies in 1985-2002. HIV Med. 2006;7(5):331-7.
Schiavini, M., Angeli, E., Mainini, A., Zerbi, P., Duca, P. G., Gubertini, G., Vago, L., Fociani, P., Giorgi, R., & Cargnel, A. (2006). Risk factors for fibrosis progression in HIV/HCV coinfected patients from a retrospective analysis of liver biopsies in 1985-2002. HIV Medicine, 7(5), 331-7.
Schiavini M, et al. Risk Factors for Fibrosis Progression in HIV/HCV Coinfected Patients From a Retrospective Analysis of Liver Biopsies in 1985-2002. HIV Med. 2006;7(5):331-7. PubMed PMID: 16945079.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors for fibrosis progression in HIV/HCV coinfected patients from a retrospective analysis of liver biopsies in 1985-2002. AU - Schiavini,M, AU - Angeli,E, AU - Mainini,A, AU - Zerbi,P, AU - Duca,P G, AU - Gubertini,G, AU - Vago,L, AU - Fociani,P, AU - Giorgi,R, AU - Cargnel,A, PY - 2006/9/2/pubmed PY - 2007/5/22/medline PY - 2006/9/2/entrez SP - 331 EP - 7 JF - HIV medicine JO - HIV Med VL - 7 IS - 5 N2 - OBJECTIVES: To identify predictive factors for moderate/severe liver fibrosis and to analyse fibrosis progression in paired liver biopsies from HIV-positive patients with chronic hepatitis C virus (HCV) infection. METHODS: HIV/HCV coinfected patients followed at the 2nd Department of Infectious Diseases of L. Sacco Hospital in Milan, Italy, with at least one liver biopsy specimen were retrospectively evaluated. RESULTS: A total of 110 patients were enrolled in the study. In a univariate analysis, predictive factors of Ishak-Knodell stage > or =3 were a history of alcohol abuse [odds ratio (OR) 3.6, P=0.004], alanine aminotransferase level >100 IU/L at biopsy (OR 2.4, P=0.05), necro-inflammatory grade > or =9 (OR 37.14, P<0.0001) and CD4 count <350 cells/microL at nadir (OR 5.3, P=0.05). In a multivariate analysis, age >35 years (OR 3.19, P=0.04) and alcohol abuse (OR 4.36, P=0.002) remained independently associated with Ishak-Knodell stage. Paired liver biopsies were available in 36 patients; 18 showed an increase of at least one stage in the subsequent liver biopsy. Either in a univariate or in a multivariate analysis, a decrease of CD4 cell count of more than 10% between two biopsies (OR 6.85, P=0.002) was significantly associated with liver fibrosis progression. CONCLUSION: Our findings highlight the relevance of encouraging a withdrawal of alcohol consumption in people with chronic HCV infection and of carrying out close follow-up of patients, especially if they are more than 35 years old. It is therefore mandatory to evaluate HIV/HCV coinfected patients for anti-HCV treatment and to increase CD4 cell count through antiretroviral therapy in order to reduce the risk of fibrosis progression and to slow the evolution of liver disease. SN - 1464-2662 UR - https://www.unboundmedicine.com/medline/citation/16945079/Risk_factors_for_fibrosis_progression_in_HIV/HCV_coinfected_patients_from_a_retrospective_analysis_of_liver_biopsies_in_1985_2002_ L2 - https://doi.org/10.1111/j.1468-1293.2006.00384.x DB - PRIME DP - Unbound Medicine ER -