14th International AIDS Conference


Barcelona, Spain — July 7-12, 2002

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[TITLE:] Progression rate of liver fibrosis in human immunodeficiency virus and Hepatitis C virus coinfected patients, UK experience

[AUTHOR(S):] A.H. Mohsen, C. Taylor, B. Portmann, S. Norris, R. Kulasegaram, S. Murad, P. Easterbrook1

Int Conf AIDS. 2002 Jul 7-12;14:Abstract No. MoOrB1057

[ABSTRACT:] Introduction: There is limited comparative histological data on the relative rate of HCV progression in patients with human immunodeficiency virus (HIV) and hepatitis C (HCV)co-infection.

Aim: To compare the progression of hepatic fibrosis in HIV-HCV coinfected and HCV infected patients.

METHODS: Patients were included only if the duration of HCV infection were known. Detailed epidemiological data were collected. Liver biopsies were graded using Ishak scoring system by a single experienced observer.

RESULTS: 33 HCV-HIV coinfected and 95 HCV infected alone were analyzed. The majority were males 73% and receiving HAART (82%). Risk factors included intravenous drug use in 81% and blood products/transfusion in 19%. Median progression rate in coinfected patients is fibrosis 0.19 unit/year comparing with 0.133 in HCV infected alone (p= 0.008). The estimated time from infection to established cirrhosis in coinfected patients is 21.05 years compared with 30.75 in HCV alone. There were no significant differences in sex distribution (p=0.81), fibrosis stage (p=0.09), ALT (p=0.83), age at infection (p=0.98) and duration of HCV (p=0.74). Patients with HIV co-infection had significantly higher inflammatory grade (p=0.001) despite having lower alcohol intake (p=0.003). Univariate and multivariable analysis correcting for alcohol and inflammatory grade showed HIV to be significantly associated with faster fibrosis progression at p values of (p=0.01) and (p=0.05) respectively.

CONCLUSIONS: HIV-HCV co-infected patients have more rapid rate of fibrosis progression and higher inflammatory grades compared to HCV infected patients.

Presenting author: Abdul Hadi Mohsen

1King's College, University of London, Department of HIV/GU Medicine, Weston Education Centre, Cutecombe Road, London, United Kingdom.

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