Journal Article

Liver Biopsy Findings for HIV-Infected Patients with Chronic Hepatitis C and Persistently Normal Levels of Alanine Aminotransferase

Matilde Sánchez-Conde, Juan Berenguer, Pilar Miralles, Federico Alvarez, Juan Carlos Lopez, Jaime Cosin, Catalán Pilar, Margarita Ramçrez, Isabel Gutierrez and Emilio Alvarez

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 43, issue 5, pages 640-644
Published in print September 2006 | ISSN: 1058-4838
Published online September 2006 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/506440
Liver Biopsy Findings for HIV-Infected Patients with Chronic Hepatitis C and Persistently Normal Levels of Alanine Aminotransferase

More Like This

Show all results sharing these subjects:

  • Infectious Diseases
  • Immunology
  • Public Health and Epidemiology
  • Microbiology

GO

Show Summary Details

Preview

Background. Severe liver fibrosis is common in patients coinfected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) who have a high alanine aminotransferase (ALT) level. However, little is known about the frequency, liver biopsy findings, and significance of a persistently normal ALT level in coinfected patients.

Methods. We analyzed clinical data and histological findings for 256 patients coinfected with HIV and HCV, 24 (9.4%) of whom had an ALT level within the normal range on 2 separate occasions within a 6-month period.

Results. The proportion of patients demonstrating advanced stages of fibrosis (F3 and F4) was 78 (33.7%) of 232 patients in the high ALT level group, compared with 0 (0%) of 24 patients in the persistently normal ALT level group (P < .001). Among patients with persistently normal ALT levels, 23 (96%) had any grade of fibrosis, and 7 (29%) had stage F2 of fibrosis. No differences were found between both groups with respect to age, sex, HIV transmission category, Centers for Disease Control and Prevention clinical category, CD4+ cell count (both nadir and baseline values), type of antiretroviral therapy, years since onset of HCV infection, alcohol use, or HCV load. However, the proportion of patients infected with HCV genotype 3 was significantly higher among patients with high ALT levels than in patients with persistently normal ALT levels (61 [26.9%] of 232 patients vs. 1 [4.2%] of 24 patients; P = .04).

Conclusions. Histological abnormalities are significantly milder in patients coinfected with HIV and HCV who have persistently normal ALT levels than those found in patients with high ALT levels. However, a subgroup of patients with persistently normal ALT levels may have significant cases of fibrosis. Liver biopsy may be recommendable in patients coinfected with HIV and HCV who have persistently normal ALT levels, to determine the extent of liver fibrosis and, consequently, to assess suitability for treatment.

Journal Article.  3036 words.  Illustrated.

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

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.