BACKGROUND: Chronic hepatitis C is more aggressive during HIV infection. Available data about risk factors of liver fibrosis in HIV/HCV co-infected patients derive from studies based on a single liver biopsy. OBJECTIVES: To evaluate the risk factors of liver fibrosis progression (LFP) and to investigate the role of antiretroviral therapy (ARV) in HIV/HCV patients who underwent paired liver biopsy. PATIENTS AND METHODS: We retrospectively studied 58 patients followed at two Infectious Diseases Departments in Northern Italy during the period 1988-2005. All specimens were double-blinded and centrally examined by two pathologists. LFP was defined when an increase of at least one stage occurred in the second biopsy, according to the Ishak-Knodell classification. RESULTS: In a univariate analysis, serum levels of alanine aminotransferase (ALT) > 150 IU/L at the first biopsy (P = 0.02), and a > 20% decrease in CD4+ cell count between the two biopsies (P = 0.007), were significantly associated with LFP. In multivariate analysis, a > 20% decrease in CD4+ cell count remained independently associated to LFP (Odds Ratio, 3.99; 95% confidence interval, 1.25-12.76; P < 0.02). Analysis of life survival curves confirmed the correlation between CD4+ cell count and LFP. CONCLUSIONS: Our findings highlight that in HIV/HCV coinfected patients, an effective antiretroviral therapy that assures a good immune-virological profile contributes to reducing the risk of LFP
Fibrosis progression in paired liver biopsies from HIV/HCV co-infected patients / M. Schiavini, E. Angeli, A. Mainini, C. Uberti-Foppa, P. Zerbi, C. Sagnelli, A. Cargnel, G. Vago, P.G. Duca, R. Giorgi, G. Rizzardini, G. Gubertini. - In: HEPATITIS MONTHLY. - ISSN 1735-143X. - 11:7(2011 Jul 01), pp. 525-531.
|Titolo:||Fibrosis progression in paired liver biopsies from HIV/HCV co-infected patients|
|Parole Chiave:||Antiretroviral therapy; HCV; HIV; Liver fibrosis|
|Settore Scientifico Disciplinare:||Settore MED/08 - Anatomia Patologica|
Settore MED/17 - Malattie Infettive
|Data di pubblicazione:||1-lug-2011|
|Appare nelle tipologie:||01 - Articolo su periodico|