Factors influencing liver fibrosis and necroinflammation in HIV/HCV coinfection and HCV monoinfection

C. Sagnelli, C. Uberti-Foppa, G. Pasquale, S. De Pascalis, N. Coppola, L. Albarello, C. Doglioni, A. Lazzarin, E. Sagnelli

Research output: Contribution to journalArticle

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Abstract

Objectives: To define differences in liver histology between HIV/HCV coinfection and HCV monoinfection, and to investigate possible causative factors. Methods: Liver biopsies (LBs) from 440 consecutive HIV/HCV-coinfected patients (Group HIV/HCV) and 374 consecutive HCV-monoinfected patients (Group HCV) were evaluated for necroinflammation and fibrosis (Ishak) by a pathologist unaware of the clinical and laboratory data. All patients were HBsAg-negative, with no history of alcohol abuse and naïve to anti-HCV treatment. At LB, 78.4 % of patients in Group HIV/HCV were on an antiretroviral regimen. Results: HIV/HCV-coinfected patients compared to the HCV-monoinfected patients were younger (p <0.0001), more frequently males (p <0.0001), and had HCV genotype 3 (p <0.0001); they showed a good immunological condition (CD4+ cell count: 518 ± 166 cells/mm3). Patients in Group HIV/HCV more frequently showed a fibrosis score ≥4 (27.5 vs. 20.6 %, p <0.05) and a necroinflammation score ≥9 (25.9 vs. 13.4 %; p <0.0001). The prevalence of patients with fibrosis score ≥4 was significantly higher in older age classes in both Group HIV/HCV (p <0.005) and Group HCV (p <0.05). A necroinflammation score ≥9 was significantly higher in older age classes only in Group HIV/HCV (p <0.05). A multivariate analysis for Group HIV/HCV revealed that the patient age and nadir of CD4+ cell count were independently associated to higher degrees of fibrosis, the patient age and antiretroviral treatment were associated to higher degrees of necroinflammation, and HCV genotype 3 was associated to higher degrees of steatosis. Conclusion: The data suggest a need for early anti-HCV treatment in both HCV-monoinfected and HIV/HCV-coinfected patients.

Original languageEnglish
Pages (from-to)959-967
Number of pages9
JournalInfection
Volume41
Issue number5
DOIs
Publication statusPublished - Oct 2013

Fingerprint

Coinfection
Liver Cirrhosis
HIV
Fibrosis
CD4 Lymphocyte Count
Liver
Genotype
Biopsy
Hepatitis B Surface Antigens
Alcoholism
Histology
Therapeutics
Multivariate Analysis

Keywords

  • HIV/HCV coinfection
  • Liver biopsy
  • Liver cell necrosis
  • Liver fibrosis
  • Liver histology

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Factors influencing liver fibrosis and necroinflammation in HIV/HCV coinfection and HCV monoinfection. / Sagnelli, C.; Uberti-Foppa, C.; Pasquale, G.; De Pascalis, S.; Coppola, N.; Albarello, L.; Doglioni, C.; Lazzarin, A.; Sagnelli, E.

In: Infection, Vol. 41, No. 5, 10.2013, p. 959-967.

Research output: Contribution to journalArticle

Sagnelli, C, Uberti-Foppa, C, Pasquale, G, De Pascalis, S, Coppola, N, Albarello, L, Doglioni, C, Lazzarin, A & Sagnelli, E 2013, 'Factors influencing liver fibrosis and necroinflammation in HIV/HCV coinfection and HCV monoinfection', Infection, vol. 41, no. 5, pp. 959-967. https://doi.org/10.1007/s15010-013-0502-3
Sagnelli, C. ; Uberti-Foppa, C. ; Pasquale, G. ; De Pascalis, S. ; Coppola, N. ; Albarello, L. ; Doglioni, C. ; Lazzarin, A. ; Sagnelli, E. / Factors influencing liver fibrosis and necroinflammation in HIV/HCV coinfection and HCV monoinfection. In: Infection. 2013 ; Vol. 41, No. 5. pp. 959-967.
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AU - Pasquale, G.

AU - De Pascalis, S.

AU - Coppola, N.

AU - Albarello, L.

AU - Doglioni, C.

AU - Lazzarin, A.

AU - Sagnelli, E.

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N2 - Objectives: To define differences in liver histology between HIV/HCV coinfection and HCV monoinfection, and to investigate possible causative factors. Methods: Liver biopsies (LBs) from 440 consecutive HIV/HCV-coinfected patients (Group HIV/HCV) and 374 consecutive HCV-monoinfected patients (Group HCV) were evaluated for necroinflammation and fibrosis (Ishak) by a pathologist unaware of the clinical and laboratory data. All patients were HBsAg-negative, with no history of alcohol abuse and naïve to anti-HCV treatment. At LB, 78.4 % of patients in Group HIV/HCV were on an antiretroviral regimen. Results: HIV/HCV-coinfected patients compared to the HCV-monoinfected patients were younger (p <0.0001), more frequently males (p <0.0001), and had HCV genotype 3 (p <0.0001); they showed a good immunological condition (CD4+ cell count: 518 ± 166 cells/mm3). Patients in Group HIV/HCV more frequently showed a fibrosis score ≥4 (27.5 vs. 20.6 %, p <0.05) and a necroinflammation score ≥9 (25.9 vs. 13.4 %; p <0.0001). The prevalence of patients with fibrosis score ≥4 was significantly higher in older age classes in both Group HIV/HCV (p <0.005) and Group HCV (p <0.05). A necroinflammation score ≥9 was significantly higher in older age classes only in Group HIV/HCV (p <0.05). A multivariate analysis for Group HIV/HCV revealed that the patient age and nadir of CD4+ cell count were independently associated to higher degrees of fibrosis, the patient age and antiretroviral treatment were associated to higher degrees of necroinflammation, and HCV genotype 3 was associated to higher degrees of steatosis. Conclusion: The data suggest a need for early anti-HCV treatment in both HCV-monoinfected and HIV/HCV-coinfected patients.

AB - Objectives: To define differences in liver histology between HIV/HCV coinfection and HCV monoinfection, and to investigate possible causative factors. Methods: Liver biopsies (LBs) from 440 consecutive HIV/HCV-coinfected patients (Group HIV/HCV) and 374 consecutive HCV-monoinfected patients (Group HCV) were evaluated for necroinflammation and fibrosis (Ishak) by a pathologist unaware of the clinical and laboratory data. All patients were HBsAg-negative, with no history of alcohol abuse and naïve to anti-HCV treatment. At LB, 78.4 % of patients in Group HIV/HCV were on an antiretroviral regimen. Results: HIV/HCV-coinfected patients compared to the HCV-monoinfected patients were younger (p <0.0001), more frequently males (p <0.0001), and had HCV genotype 3 (p <0.0001); they showed a good immunological condition (CD4+ cell count: 518 ± 166 cells/mm3). Patients in Group HIV/HCV more frequently showed a fibrosis score ≥4 (27.5 vs. 20.6 %, p <0.05) and a necroinflammation score ≥9 (25.9 vs. 13.4 %; p <0.0001). The prevalence of patients with fibrosis score ≥4 was significantly higher in older age classes in both Group HIV/HCV (p <0.005) and Group HCV (p <0.05). A necroinflammation score ≥9 was significantly higher in older age classes only in Group HIV/HCV (p <0.05). A multivariate analysis for Group HIV/HCV revealed that the patient age and nadir of CD4+ cell count were independently associated to higher degrees of fibrosis, the patient age and antiretroviral treatment were associated to higher degrees of necroinflammation, and HCV genotype 3 was associated to higher degrees of steatosis. Conclusion: The data suggest a need for early anti-HCV treatment in both HCV-monoinfected and HIV/HCV-coinfected patients.

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KW - Liver fibrosis

KW - Liver histology

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