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8th Annual Conference Of The British HIV Association [BHIVA]19 – 21 April 2002, University of York, York |
[AUTHOR(S):] AH Mohsen, S Norris, C Taylor, R Kulasegaram, B Portmann, S Lucas, P Easterbrook, GKT HIV-HCV Collaborative Group
King's College Hospital, London
BHIVA Conf 2002 Apr 19-21;8:O29
INTRODUCTION: There are limited comparative histological data on the relative rate of HCV progression in HIV-1/HCV and HCV-infected patients.
AIM: To compare the rate of fibrosis progression in HIV/HCV coinfected and HCV mono-infected patients.
METHODS: Patients were included only if the duration of HCV infection were known. Detailed epidemiological data were collected. Liver biopsies were Ishak-scored by a single experienced observer.
RESULTS: 38 HCV/HIV co-infected cases and 95 infected with HCV alone were analysed. Most were male (73%) and had received highly active antiretroviral therapy (HAART) (82%). Risk factors included intravenous drug use in 81% and blood products/transfusion in 19%. The average progression rate in co-infected patients was 0.182 fibrosis units/year compared with 0.128 in HCV-only patients (P=0.002). The estimated time from infection to established cirrhosis in co-infected patients was 21.97 years compared with 31.25 in HCV alone. The rate of HCV progression in five patients who had repeat liver biopsies was 0.29 fibrosis units/year, equating estimate time to cirrhosis of 13.8 years. There were no significant differences in sex distribution (P=0.72), fibrosis stage (P=0.2), alanine aminotransferase (P=0.83), age at infection (P=0.98) and duration of HCV (P=0.6) between the two groups. Co-infected patients had significantly higher inflammatory grade (P=0.003) despite a lower alcohol intake (P=0.003). By multivariable analysis, HIV was significantly associated with faster fibrosis progression (P=0.01) and higher inflammatory grade (P=0.05).
CONCLUSION: HIV/HCV co-infected patients have a more rapid rate of fibrosis progression and higher inflammatory grades than patients infected with HCV only.
PRESENTING AUTHOR: AH Mohsen
020419
O29
Copyright © 2002 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD