Liver fibrosis progression in human immunodeficiency virus and hepatitis C virus coinfected patients

Abstract

The natural history of hepatitis C virus (HCV) infection in human immunodeficiency virus (HIV)-infected patientshas never been studied according to the concept of liver fibrosis progression. The aim of this work was to assess the fibrosis progression rate in HIV-HCV coinfected patients and in patients infected by HCV only. A cohort of 122 HIV-HCV coinfected patients was compared with a control group of 122 HIV-negative HCV-infected patients. Groups were matched according to age, sex, daily alcohol consumption, age at HCV infection, and duration and route of HCV infection. The fibrosis progression rate was defined as the ratio between fibrosis stage (METAVIR scoring system) and the HCV duration. The prevalence of extensive liver fibrosis (METAVIR fibrosis scores 2, 3, and 4) and moderate or severe activity were higher in HIV-infected patients (60% and 54%, respectively) than in control patients (47% and 30%, respectively; P F .05 and P F .001, respectively). The median fibrosis progression rate in coinfected patients and in control patients was 0.153 (95% confidence interval [CI], 0.117-0.181) and 0.106 (95% CI, 0.084-0.125) fibrosis units per year, respectively (P F .0001). HIV seropositivity (P F .0001), alcohol consumption (G50 g/d, P ‫؍‬ .0002), age at HCV infection (F25 years old, P F .0001), and severe immunosuppression (CD4 count I200 cells/L, P F .0001) were associated with an increase in the fibrosis progression rate. In coinfected patients, alcohol consumption (G50 g/d), CD4 count (I200 cells/L), and age at HCV infection (F25 years old) (P F .0001, respectively) were associated with a higher fibrosis progression rate. HIV seropositivity accelerates HCV-related liver fibrosis progression. In coinfected patients, a low CD4 count, alcohol consumption rate, and age at HCV infection are associated with a higher liver fibrosis progression rate. (HEPATOLOGY 1999;30:1054-1058.)

Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

“…83,100,101 Studies have shown that chronic hepatitis C patients with HIV infection have a worse prognosis as compared to those without HIV. [102][103][104][105][106][107] Coinfection with HIV and HCV is associated with a lower rate of spontaneous HCV RNA clearance. 108 There is an increased rate of fibrosis in HIV and HCV coinfected patients, with an accelerated progression of HCV-related liver disease.…”

Influence of Cannabis Use on Severity of Hepatitis C Disease

“…HCV-HIV coinfected subjects were significantly more likely to use cannabis daily and to have a prescription for medical cannabis than HCV monoinfected subjects. The recommendation to avoid cannabis use may be especially important for HCV/HIV coinfected persons given that fibrosis progression is already enhanced in this group (24).…”

Faktor - Faktor yang Berhubungan dengan Kejadian Hepatitis C pada Pasangan Seksual Pasien Koinfeksi Human Immunodeficiency Virus dan Virus Hepatitis C

“…Beberapa studi melaporkan bahwa koinfeksi HIV/HCV dapat mempercepat progresivitas penyakit ke arah sirosis hati 4,5 dan meningkatkan mortalitas yang berhubungan dengan sirosis dekompensata dan karsinoma sel hati. 3,6,7 Lebih lanjut, beberapa studi juga mendapatkan bahwa koinfeksi HIV/HCV dapat meningkatkan risiko transmisi seksual virus hepatitis C. [8][9][10][11][12] Hepatitis C paling mudah ditularkan melalui rute parenteral seperti penggunaan narkotika suntik 13 dan transfusi darah 14 , akan tetapi sulit ditularkan melalui rute seksual.…”

“…Hal ini dapat dijelaskan karena subyek penelitian merupakan pasangan heteroseksual pasien koinfeksi HIV/HCV dengan karakteristik sebagian besar laki-laki usia muda dengan rute transmisi penyalah guna narkotika suntik. 4 Karakteristik ini berbeda dengan penelitian pada pasangan monogami pasien hepatitis C kronik yang mendapatkan rerata usia pasangan dengan hepatitis C lebih tua (57,1 tahun) dan prevalensi hepatitis C meningkat dengan meningkatnya lama berpasangan. 15 Berdasarkan hal tersebut, maka lama berpasangan selama 5 tahun sebagai batasan operasional pada penelitian ini.…”