HIV-HCV coinfection speeds HCV-related liver fibrosis

(HealthDay)—Individuals who are coinfected with HIV and hepatitis C virus (HCV) exhibit liver fibrosis similar to that of individuals without HIV who are nearly 10 years older, according to research published online Feb. 26 in the Annals of Internal Medicine.

Gregory D. Kirk, M.D., M.P.H., Ph.D., of Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues conducted a cohort study involving 1,176 current and former injection drug users with antibodies to HCV (median age, 49 years) to examine whether individuals with concurrent HIV infection develop HCV-related liver disease at younger ages than those without HIV infection.

Overall, 34 percent of participants were coinfected with HIV and HCV. Compared with patients who only had HCV, the researchers found that those who were coinfected had a significantly higher prevalence of clinically significant fibrosis without cirrhosis and of cirrhosis. Independent correlates of liver fibrosis included increasing age and HIV infection, as well as daily alcohol use, chronic hepatitis B virus infection, body mass index greater than 25 kg/m², and elevated plasma HCV RNA levels. After accounting for these factors, HIV-infected patients exhibited liver fibrosis equal to that of people without HIV who were an average of 9.2 years older.

"In summary, persons who are coinfected with HIV and HCV have liver fibrosis stages similar to persons infected with HCV alone who are nearly one decade older," the authors write. "Additional work is needed to understand the biological basis for this observation and investigate whether effective treatment of HIV and HCV infections reduce future liver fibrosis progression."

One of the authors disclosed financial ties to the pharmaceutical industry. Support of reagents for HCV RNA testing was provided by Abbott Molecular.

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