3rd International AIDS Society Conference on HIV Pathogenesis and Treatment Rio de Janeiro - July 24 - 27, 2005

LIVER BIOPSY (LB) FINDINGS IN HIV INFECTED PATIENTS (HIV+P) WITH CHRONIC C HEPATITIS (CHC) AND PERSISTENTLY NORMAL ALANINE TRANSAMINASE (PNALT)

IAS Conf HIV Pathog Treat 2005 Jul 24-27;3rd: Abstract No. TuPe1.1C42

Sánchez-Conde M., Alvarez F., Berenguer J., Miralles P., Alvarez E., Cosin J., Lopez J.C., Ramirez M., Gutierrez I., Bellon J.M.
Gregorio Marañon Hospital, Madrid, Spain

INTRODUCTION: We analyzed liver biopsy (LB) findings in HIV infected patients (HIV+P) with chronic Hepatitis C (CHC) and persistently normal alanine transaminase (PNALT) and compared them with those found in patients with elevated ALT (EALT).

METHODS: From 9/00 to 1/05 we performed LB in 256 HIV+P with CHC as part of evaluation prior to anti-HCV therapy. Of these, 24 (9.4%) had PNALT defined as ALT levels within the normal range on two or more separate occasions within a 6 month period.

RESULTS: We found significant differences in the stage of fibrosis (Knodell score) between patients with EALT and patients with PNALT (p<0.001). EALT (N=232); 0: 0 (0%), 1: 80 (34,5%), 2: 74 (31,9%), 3: 47 (20,3%), 4: 31 (13,4%). PNALT (N=24); 0: 1 (4,2%), 1: 16 (66,7%), 2: 7 (29,2%), 3: 0 (0%), 4: 0 (0%). We found a significantly lower frequency of genotype 3 among patients with EALT in comparison with patients with PNALT 1/24; (4.2%) vs 61/232 (26.9%), p=0.04. We also found a significantly longer time on HAART in patients with EALT in comparison with patients with PNALT; median 5.3 yr vs 3.9 yr, p=0.001. No differences were found between the groups with regard to age, sex, risk group, duration of HCV infection, prior AIDS, nadir CD4+ cells, CD4+ cells and HIV viral load at LB, HCV viral load, and prior alcohol abuse.

CONCLUSIONS: In HIV+P with CHC, PNALT correlates with lower fibrosis scores than EALT. The association found between HCV genotype, duration of HAART and PNALT in this population group merits further study. Although we did not found advanced stages of fibrosis (F3 – F4) in patients with PNALT, approximately one quarter of these patients had a significant stage of fibrosis (F2). This finding suggests that LB may be indicated in HIV+P with CHC and PNALT.

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050724
Clinical | TuPe1.1C42 | Matilde Sanchez-Conde
Hepatitis viruses

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