Paper Information

Journal:   HEPATITIS MONTHLY   AUGUST 2014 , Volume 14 , Number 8; Page(s) 0 To 0.
 
Paper: 

EVALUATING LIVER FIBROSIS BY TRANSIENT ELASTOMETRY IN PATIENTS WITH HIV-HCV COINFECTION AND MONOINFECTION

 
 
Author(s):  BRESCINI LUCIA, ORSETTI ELENA, GESUITA ROSARIA, PIRACCINI FRANCESCA, MARCHIONNI ELISA, STAFFOLANI SILVIA, CASTELLI PAMELA, DRENAGGI DAVIDE, BARCHIESI FRANCESCO*
 
* DEPARTMENT OF BIOMEDICAL SCIENCES AND PUBLIC HEALTH, CLINICAL INFECTIOUS DISEASES, POLYTECHNIC UNIVERSITY OF MARCHE, ANCONA, ITALY
 
Abstract: 

Background: Due to the high efficacy of combination antiretroviral therapy (cART), the number of patients living with HIV is increasing. Chronic HCV infection has become a leading cause of non-AIDS related morbidity and mortality in patients with HIV infection.
Objectives: The aim of this cross-sectional study was to identify factors associated with liver fibrosis (LF) in patients with HIV monoinfection and HIV-HCV coinfection.
Patients and Methods: We analyzed LF by transient elastometry ([TE], Fibroscan) in three groups of patients (HIV, HIV-HCV and HCV) followed at the Infectious Diseases Department of University of Ancona, Italy, between October 2009 and November 2012.
Results: In total, 354 adults including 98 HIV, 70 HIV-HCV and 186 HCV patients were studied. HIV-HCV patients had a longer duration of HIV (P
<0.006) and HCV (P<0.001) infections. Additionally, they were receiving cART therapy for a longer period (P<0.001); they had higher prevalence of lipodystrophy (P<0.001) and higher HCV load (P=0.004). LF was significantly more pronounced in HCV and HIV-HCV compared to HIV patients (P<0.001). A total of 13.3%, 39.2% and 51.4% of HIV, HCV and HIV-HCV, respectively, showed a LF³F2. Additionally, a severe LF (F=4) was significantly more frequent among HIV-HCV compared to other groups. A longer exposure to didanosine, stavudine, lopinavir/ritonavir and fosamprenavir resulted in increased LF by univariate analysis (P ranging from<0.001 to 0.007). By logistic regression analysis, the only variables significantly associated with increased LF were HCV coinfection, older age, and high AST values (P ranging from<0.001 to 0.036).
Conclusions: HCV coinfection, older age and AST were associated with LF in patients with HIV infection.

 
Keyword(s): COINFECTION, LIVER FIBROSIS, TRANSIENT ELASTOMETRY
 
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