Journal Article

Incidence and Predictors of Severe Liver Fibrosis in Human Immunodeficiency Virus—Infected Patients with Chronic Hepatitis C: A European Collaborative Study

Luz Martín-Carbonero, Yves Benhamou, Massimo Puoti, Juan Berenguer, José Mallolas, Carmen Quereda, Ana Arizcorreta, Antonio Gonzalez, Jurgen Rockstroh, Victor Asensi, Pilar Miralles, Montse Laguno, Leonor Moreno, José Antonio Girón, Martin Vogel, Javier García-Samaniego, Marina Nuñez, Miriam Romero, Santiago Moreno, Juan José de la Cruz and Vincent Soriano

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 38, issue 1, pages 128-133
Published in print January 2004 | ISSN: 1058-4838
Published online January 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/380130
Incidence and Predictors of Severe Liver Fibrosis in Human Immunodeficiency Virus—Infected Patients with Chronic Hepatitis C: A European Collaborative Study

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A study was performed in 10 European health care centers in which 914 patients coinfected with hepatitis C virus (HCV) and human immunodeficiency virus (HIV) who had elevated serum alanine aminotransferase (ALT) levels underwent liver biopsy during the period of 1992 through 2002. Overall, the METAVIR liver fibrosis stage was F0 in 10% of patients, F1 in 33%, F2 in 22%, F3 in 22%, and F4 in 13%. Predictors of severe liver fibrosis (METAVIR stage, F3 or F4) in multivariate analysis were age of >35 years (odds ratio [OR], 2.95; 95% confidence interval [CI], 2.08–4.18), alcohol consumption of >50 g/day (OR, 1.61; 95% CI, 1.1–2.35), and CD4+ T cell count of <500 cells/mm3 (OR, 1.43; 95% CI, 1.03–1.98). Forty-six percent of patients aged >40 years had severe liver fibrosis, compared with 15% of subjects aged <30 years. The use of antiretroviral therapy was not associated with the severity of liver fibrosis. In summary, severe liver fibrosis is frequently found in HCV-HIV-coinfected patients with elevated serum ALT levels, and its severity increases significantly with age. The rate of complications due to end-stage liver disease will inevitably increase in this population, for whom anti-HCV therapy should be considered a priority.

Journal Article.  3562 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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