Fibrosis progression in paired liver biopsies from HIV/HCV co-infected patients

authors:

avatar Monica Schiavini 1 , * , avatar Elena Angeli 2 , avatar Annalisa Mainini 2 , avatar Caterina Uberti-Foppa 2 , avatar Pietro Zerbi 2 , avatar Caterina Sagnelli 2 , avatar Antonietta Cargnel 2 , avatar Gianluca Vago 2 , avatar Pier Giorgio Duca 2 , avatar Riccardo Giorgi 2 , avatar Giuliano Rizzardini 2 , avatar Guido Gubertini 2

Department of Infectious Diseases, L. Sacco Hospital, schiavini.monica@hsacco.it, Italy
Department of Infectious Diseases, L. Sacco Hospital, Italy
Hepatitis Monthly: Vol.11, issue 7; 525-531
article type: Research Article
received: October 16, 2010
accepted: April 2, 2011

how to cite: Schiavini M, Angeli E, Mainini A, Uberti-Foppa C, Zerbi P, et al. Fibrosis progression in paired liver biopsies from HIV/HCV co-infected patients. Hepat Mon. 2011;11(7): 525-531. 

Abstract

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.

  • Implication for health policy/practice/research/medical education:
    Chronic hepatitis C is a common problem in HIV patients that leads to liver fibrosis. This study investigates ARV therapy in c0-infected HIV/HCV patients who are the case of paired liver biopsy. Therefore, study of this article is recommended to all researchers in the field of public health, diagnosis and treatment of HIV and/or HCV patients.
  • Please cite this paper as:
    Schiavini M, Angeli E, Mainini A, Uberti-Foppa C, Zerbi P, Sagnelli C, et al. Fibrosis progression in paired liver biopsies from HIV/HCV co-infected patients. Hepat Mon. 2011;11(7):525-31.

© 2011 Kowsar M.P.Co. All rights reserved.

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