[984] FIBROSIS PROGRESSION IN 914 HIV-HCV CO-INFECTED PATIENTS IS STRONGLY RELATED WITH AGE: AN EUROPEAN COLLABORATIVE STUDY

2nd International AIDS Society Conference on HIV Pathogenesis and Treatment

Paris, France - July 13 - 16, 2003

[TITLE:] FIBROSIS PROGRESSION IN 914 HIV-HCV CO-INFECTED PATIENTS IS STRONGLY RELATED WITH AGE: AN EUROPEAN COLLABORATIVE STUDY

[AUTHOR(S):] L Martin-Carbonero¹, V Soriano¹, Y Benhamou², M Puoti³, J Mallolas⁴, J Berenguer⁵, J Rockstroh⁶, C Quereda⁷, L Moreno⁷, M Laguno⁴, A Arizcorreta⁸, P Miralles⁵, JA Giron⁸, V Asensi⁹, A Gonzalez¹⁰, M Vogel⁶, J Garcia-Samaniego¹, S Moreno⁷ and J De La Cruz¹¹
¹Instituto de Salud Carlos III, Madrid, Spain; ²Hopital Pitié- Salpêtrière, Paris, France; ³Spedali Civili; ⁴Brescia, Italy, Hospital Clinic, Barcelona, Spain; ⁵Hospital Gregorio Marañón, Madrid, Spain; ⁶University Hospital, Bonn, Germany; ⁷Hospital Ramón y Cajal, Madrid, Spain, ⁸Hospital Puerta del Mar, Cadiz, Spain; ⁹Hospital General, Oviedo, Spain; ¹⁰Centros Penitenciarios, Madrid, Spain; and ¹¹Universidad Autónoma, Madrid, Spain

IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd: Abstract No. 984
Antiviral Therapy 2003; 8(Suppl. 1):S462

[ABSTRACT:] Background: Chronic hepatitis C is becoming one of the leading causes of morbidity and mortality among HIV+ persons infected parenterally. Liver fibrosis progress faster in HIV patients. Factors involved in fibrosis progression in the HAART era are less defined.

Patients and methods: This is a European, multicentre, retrospective survey. Main demographics, clinical, laboratory, and histological findings from HIV/HCV-co-infected patients with elevated ALT levels, were recorded. Univariate and multivariate multinomial logistic regression analysis was performed to calculate odds ratio (OR) and 95% confidence intervals (95% CIs) for having moderate (F2) or severe fibrosis (F3–F4) with respect to lack or mild fibrosis (F0–F1).

Results: 914 patients were included. 75% were male, 83% IDUs and 25% admitted former or current alcohol intake >80 g/d. Median age and HCV estimated duration of infection were 37 and 16 years, respectively. Median CD4 count was 480 cells/µl. 70% were on antiretroviral treatment. HCV genotype was 1 (56%), 2 (2%), 3 (32%) and 4 (9%). Liver fibrosis stage was F0 (10%), F1 (33%), F2 (22%), F3 (22%) and F4 (13%). It was 8%, 28%, 20%, 25% and 18% for patients older than 35 years. In the multivariate analysis, older age and higher alcohol intake were the only factors related to higher fibrosis grades. OR (95% CI) for F2 or F3–F4 in respect to F0–F1 were as follow. High alcohol intake: for F2 1.4 (1–2.5), for F3–F4 2 (1.25–2.5); P=0.006. Age >35: for F2 1.25 (0.9–2); 3.3 (2–5); P<0.001 Gender, age at infection, HCV genotype, HCV load, CD4 counts or antiretroviral treatment were nor related with fibrosis.

Conclusions: Up to 1/3 of HIV/HCV-co-infected patients show advanced liver fibrosis. As this rate increase with age, more complications due to endstage liver disease should be expected. Given that fibrosis progresses with age and treatment response decreases in cirrhotics, HCV therapy should not be delayed in most HIV/HCV-co-infected patients.

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