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Liver fibrosis in patients with chronic hepatitis C and persistently normal liver enzymes: influence of HIV infection.
J Viral Hepat. 2009 Nov; 16(11):790-5.JV

Abstract

Liver fibrosis progress slowly in patients with chronic hepatitis C and persistently normal alanine aminotransferase (PNALT) compared to subjects with elevated aminotransferases. Differences in liver fibrosis according to human immunodeficiency virus (HIV) status in this population have not been examined. All patients with serum hepatitis C virus (HCV)-RNA and PNALT who underwent liver fibrosis assessment using elastometry since 2004 at three different European hospitals were evaluated. Patients previously treated with interferon were excluded. PNALT was defined as ALT below the upper limit of normality in at least three consecutive determinations within the last 12 months. Fibrosis stage was defined as mild (Metavir F0-F1) if stiffness < or =7.1 kPa; moderate (F2) if 7.2-9.4 kPa; severe (F3) if 9.5-14 kPa, and cirrhosis (F4) if >14 kPa. A total of 449 HIV-negative and 133 HIV-positive patients were evaluated. HIV-negative patients were older (mean age 51.8 vs 43.5 years) and more frequently females (63%vs 37%) than the HIV counterparts. Mean serum HCV-RNA was similar in both the groups (5.9 vs 5.8 log IU/mL). Overall, 78.8% of the HIV patients were on HAART and their mean CD4 count was 525 (+/-278) cells/microL. In HIV-negatives, liver fibrosis was mild in 84.6%; moderate in 8.7%, severe in 3.3% and cirrhosis was found in 3.3%. In HIV patients, these figures were 70.7%, 18.8%, 6%, and 4.5%, respectively. In the multivariate logistic regression analysis, older age (odds ratio or OR: 1.04; 95% confidence interval or CI: 1.02-1.07; P < 0.001) and being HIV+ (OR: 2.6; 95% CI: 1.21-5.85; P < 0.01) were associated with severe liver fibrosis or cirrhosis (F3-F4). Thus, severe liver fibrosis and cirrhosis are seen in 6.6% of the HCV-monoinfected and in 10.5% of HCV-HIV co-infected patients with PNALT. Some degree of liver fibrosis that justifies treatment is seen in 15% of the HCV-monoinfected but doubles to nearly 30% in HIV-HCV co-infected patients with PNALT.

Authors+Show Affiliations

Infectious Diseases Department, Hospital Carlos III, Madrid, Spain. lmcarbonero@gmail.comNo 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 availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

19413693

Citation

Martin-Carbonero, L, et al. "Liver Fibrosis in Patients With Chronic Hepatitis C and Persistently Normal Liver Enzymes: Influence of HIV Infection." Journal of Viral Hepatitis, vol. 16, no. 11, 2009, pp. 790-5.
Martin-Carbonero L, de Ledinghen V, Moreno A, et al. Liver fibrosis in patients with chronic hepatitis C and persistently normal liver enzymes: influence of HIV infection. J Viral Hepat. 2009;16(11):790-5.
Martin-Carbonero, L., de Ledinghen, V., Moreno, A., Maida, I., Foucher, J., Barreiro, P., Romero, M., Satta, G., Garcia-Samaniego, J., Gonzalez-Lahoz, J., & Soriano, V. (2009). Liver fibrosis in patients with chronic hepatitis C and persistently normal liver enzymes: influence of HIV infection. Journal of Viral Hepatitis, 16(11), 790-5. https://doi.org/10.1111/j.1365-2893.2009.01133.x
Martin-Carbonero L, et al. Liver Fibrosis in Patients With Chronic Hepatitis C and Persistently Normal Liver Enzymes: Influence of HIV Infection. J Viral Hepat. 2009;16(11):790-5. PubMed PMID: 19413693.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Liver fibrosis in patients with chronic hepatitis C and persistently normal liver enzymes: influence of HIV infection. AU - Martin-Carbonero,L, AU - de Ledinghen,V, AU - Moreno,A, AU - Maida,I, AU - Foucher,J, AU - Barreiro,P, AU - Romero,M, AU - Satta,G, AU - Garcia-Samaniego,J, AU - Gonzalez-Lahoz,J, AU - Soriano,V, Y1 - 2009/04/28/ PY - 2009/5/6/entrez PY - 2009/5/6/pubmed PY - 2010/1/13/medline SP - 790 EP - 5 JF - Journal of viral hepatitis JO - J Viral Hepat VL - 16 IS - 11 N2 - Liver fibrosis progress slowly in patients with chronic hepatitis C and persistently normal alanine aminotransferase (PNALT) compared to subjects with elevated aminotransferases. Differences in liver fibrosis according to human immunodeficiency virus (HIV) status in this population have not been examined. All patients with serum hepatitis C virus (HCV)-RNA and PNALT who underwent liver fibrosis assessment using elastometry since 2004 at three different European hospitals were evaluated. Patients previously treated with interferon were excluded. PNALT was defined as ALT below the upper limit of normality in at least three consecutive determinations within the last 12 months. Fibrosis stage was defined as mild (Metavir F0-F1) if stiffness < or =7.1 kPa; moderate (F2) if 7.2-9.4 kPa; severe (F3) if 9.5-14 kPa, and cirrhosis (F4) if >14 kPa. A total of 449 HIV-negative and 133 HIV-positive patients were evaluated. HIV-negative patients were older (mean age 51.8 vs 43.5 years) and more frequently females (63%vs 37%) than the HIV counterparts. Mean serum HCV-RNA was similar in both the groups (5.9 vs 5.8 log IU/mL). Overall, 78.8% of the HIV patients were on HAART and their mean CD4 count was 525 (+/-278) cells/microL. In HIV-negatives, liver fibrosis was mild in 84.6%; moderate in 8.7%, severe in 3.3% and cirrhosis was found in 3.3%. In HIV patients, these figures were 70.7%, 18.8%, 6%, and 4.5%, respectively. In the multivariate logistic regression analysis, older age (odds ratio or OR: 1.04; 95% confidence interval or CI: 1.02-1.07; P < 0.001) and being HIV+ (OR: 2.6; 95% CI: 1.21-5.85; P < 0.01) were associated with severe liver fibrosis or cirrhosis (F3-F4). Thus, severe liver fibrosis and cirrhosis are seen in 6.6% of the HCV-monoinfected and in 10.5% of HCV-HIV co-infected patients with PNALT. Some degree of liver fibrosis that justifies treatment is seen in 15% of the HCV-monoinfected but doubles to nearly 30% in HIV-HCV co-infected patients with PNALT. SN - 1365-2893 UR - https://www.unboundmedicine.com/medline/citation/19413693/Liver_fibrosis_in_patients_with_chronic_hepatitis_C_and_persistently_normal_liver_enzymes:_influence_of_HIV_infection_ L2 - https://doi.org/10.1111/j.1365-2893.2009.01133.x DB - PRIME DP - Unbound Medicine ER -