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Differences in liver fibrosis and response to pegylated interferon plus ribavirin in HIV/HCV-coinfected patients with normal vs elevated liver enzymes.
J Viral Hepat. 2010 Dec; 17(12):866-71.JV

Abstract

Severity of liver fibrosis and response to pegylated interferon plus ribavirin (pegIFN-RBV) are not well known in HIV/HCV-coinfected patients with persistently normal alanine aminotransferase (PNALT). All HIV/HCV-coinfected patients who had been assessed for liver fibrosis using elastometry during 2005 at our clinic were evaluated. Those with at least 1 year with three prior consecutive ALT measurements below the upper limit of normality were compared with patients with elevated ALT. Response to pegIFN-RBV was assessed in a subset of these patients. We analysed 87 patients with PNALT and 122 with elevated ALT. Compared to patients with elevated ALT, those with PNALT were significantly more often women (42%vs 26%), had greater mean CD4 counts (565 vs 420 cells/mm³), had lower mean serum HCV-RNA (5.8 vs 6.2 log IU/ml) and were infected by HCV genotype 4 (33%vs 6%). Liver fibrosis was considered as severe (Metavir F3) in 10% of patients with PNALT, and another 4% had cirrhosis based on stiffness values. These numbers were 16% and 35% in patients with elevated ALT. Treatment with pegIFN-RBV was given to 22 and 45 patients with PNALT and elevated ALT, respectively. Sustained virological response was achieved in 50% and 29% of them. In the multivariate analysis, PNALT was independently associated with response (OR: 7.9; 95% CI: 1.4-45.2; P = 0.02). Nearly 15% of HIV/HCV-coinfected patients with PNALT showed advanced liver fibrosis (Metavir F3-F4 estimates by elastometry). In summary, response to pegIFN-RBV is higher in patients with PNALT than in those with elevated ALT. Therefore, treatment should not be denied in HIV/HCV-coinfected patients with PNALT.

Authors+Show Affiliations

Infectious Diseases Department, Hospital Carlos III, Madrid, Spain.No 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

20088891

Citation

Maida, I, et al. "Differences in Liver Fibrosis and Response to Pegylated Interferon Plus Ribavirin in HIV/HCV-coinfected Patients With Normal Vs Elevated Liver Enzymes." Journal of Viral Hepatitis, vol. 17, no. 12, 2010, pp. 866-71.
Maida I, Martin-Carbonero L, Sotgiu G, et al. Differences in liver fibrosis and response to pegylated interferon plus ribavirin in HIV/HCV-coinfected patients with normal vs elevated liver enzymes. J Viral Hepat. 2010;17(12):866-71.
Maida, I., Martin-Carbonero, L., Sotgiu, G., Vispo, E., Barreiro, P., Gonzalez-Lahoz, J., & Soriano, V. (2010). Differences in liver fibrosis and response to pegylated interferon plus ribavirin in HIV/HCV-coinfected patients with normal vs elevated liver enzymes. Journal of Viral Hepatitis, 17(12), 866-71. https://doi.org/10.1111/j.1365-2893.2009.01260.x
Maida I, et al. Differences in Liver Fibrosis and Response to Pegylated Interferon Plus Ribavirin in HIV/HCV-coinfected Patients With Normal Vs Elevated Liver Enzymes. J Viral Hepat. 2010;17(12):866-71. PubMed PMID: 20088891.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Differences in liver fibrosis and response to pegylated interferon plus ribavirin in HIV/HCV-coinfected patients with normal vs elevated liver enzymes. AU - Maida,I, AU - Martin-Carbonero,L, AU - Sotgiu,G, AU - Vispo,E, AU - Barreiro,P, AU - Gonzalez-Lahoz,J, AU - Soriano,V, PY - 2010/1/22/entrez PY - 2010/1/22/pubmed PY - 2011/3/17/medline SP - 866 EP - 71 JF - Journal of viral hepatitis JO - J Viral Hepat VL - 17 IS - 12 N2 - Severity of liver fibrosis and response to pegylated interferon plus ribavirin (pegIFN-RBV) are not well known in HIV/HCV-coinfected patients with persistently normal alanine aminotransferase (PNALT). All HIV/HCV-coinfected patients who had been assessed for liver fibrosis using elastometry during 2005 at our clinic were evaluated. Those with at least 1 year with three prior consecutive ALT measurements below the upper limit of normality were compared with patients with elevated ALT. Response to pegIFN-RBV was assessed in a subset of these patients. We analysed 87 patients with PNALT and 122 with elevated ALT. Compared to patients with elevated ALT, those with PNALT were significantly more often women (42%vs 26%), had greater mean CD4 counts (565 vs 420 cells/mm³), had lower mean serum HCV-RNA (5.8 vs 6.2 log IU/ml) and were infected by HCV genotype 4 (33%vs 6%). Liver fibrosis was considered as severe (Metavir F3) in 10% of patients with PNALT, and another 4% had cirrhosis based on stiffness values. These numbers were 16% and 35% in patients with elevated ALT. Treatment with pegIFN-RBV was given to 22 and 45 patients with PNALT and elevated ALT, respectively. Sustained virological response was achieved in 50% and 29% of them. In the multivariate analysis, PNALT was independently associated with response (OR: 7.9; 95% CI: 1.4-45.2; P = 0.02). Nearly 15% of HIV/HCV-coinfected patients with PNALT showed advanced liver fibrosis (Metavir F3-F4 estimates by elastometry). In summary, response to pegIFN-RBV is higher in patients with PNALT than in those with elevated ALT. Therefore, treatment should not be denied in HIV/HCV-coinfected patients with PNALT. SN - 1365-2893 UR - https://www.unboundmedicine.com/medline/citation/20088891/Differences_in_liver_fibrosis_and_response_to_pegylated_interferon_plus_ribavirin_in_HIV/HCV_coinfected_patients_with_normal_vs_elevated_liver_enzymes_ L2 - https://doi.org/10.1111/j.1365-2893.2009.01260.x DB - PRIME DP - Unbound Medicine ER -