Prevalence and factors associated with significant liver fibrosis assessed by transient elastometry in HIV/hepatitis C virus-coinfected patients

[Guest guest]

http://www.ingentaconnect.com/content/bsc/jvh/2010/00000017/00000010/art00006

Journal of Viral Hepatitis, Volume 17, Number 10

Prevalence and factors associated with significant liver fibrosis assessed by

transient elastometry in HIV/hepatitis C virus-coinfected patients

Authors: Pineda, J. A.1; González, J.2; Ortega, E.3; Tural, C.4; Macías, J.1;

Griffa, L.5; Burgos, A.5

Source: Journal of Viral Hepatitis, Volume 17, Number 10, October 2010 , pp.

714-719(6)

Publisher: Wiley-Blackwell

Abstract:

Summary. 

Transient elastometry (TE) could provide a more accurate evaluation of the

frequency and risk factors of liver fibrosis in hepatitis C virus (HCV)

infection than that based on biopsy. The aim of this study was to assess the

prevalence of and factors associated with significant liver fibrosis in a large

population of HIV/HCV-coinfected patients. HIV/HCV-coinfected patients, who had

participated in a cross-sectional, multicenter, retrospective study of liver

fibrosis using noninvasive markers and in whom a determination of liver

stiffness (LS) by TE was available, were included in this analysis. Factors

potentially associated with significant fibrosis (LS ≥ 9 kPa) were

analyzed. One thousand three hundred and ten patients fulfilled the inclusion

criteria, 526 (40%) of them showed LS ≥ 9 kPa and 316 (24%) cirrhosis

(LS ≥ 14 kPa). The factors independently associated with significant

fibrosis [adjusted odds ratio (95% confidence interval, P value) were the

following: older age [1.04 (1.01-1.07), 0.002], daily alcohol intake

> 50 g/day [1.58 (1.10-2.27), 0.013] and the length of HCV infection [1.03

(1.00-1.06), 0.023]]. A CD4 cell count lower than < 200 per mm3 [1.67

(0.99-2.81), 0.053] and HCV genotype 4 [0.66 (0.42-1.02), 0.066] were marginally

associated with LS ≥ 9 kPa. In conclusion, the prevalence of cirrhosis

in HIV/HCV-coinfected patients seems to be higher than previously reported in

studies based on liver biopsy. Older age, alcohol consumption and lower CD4 cell

counts are related with significant fibrosis. The latter association supports an

earlier starting of antiretroviral therapy in this setting.

Document Type: Research article

DOI: 10.1111/j.1365-2893.2009.01229.x

Affiliations: 1: Unit of Infectious Diseases, Hospital Universitario de Valme,

Seville 2: Hospital Universitario La Paz, Madrid 3: Hospital Clínico, Valencia

4: Hospital Germans Trias i Pujol, Badalona 5: Abbott Laboratories, Madrid,

Spain