9TH EUROPEAN AIDS CONFERENCE (EACS) 1st EACS RESISTANCE & PHARMACOLOGY WORKSHOP October 25 - 29, 2003 Warsaw, Poland

Background: Proton MR spectroscopy (1H MRS) provides in vivo determination of metabolic concentration in body tissue and may be used as non-invasive tool to assess the status of liver damage. We evaluated 1H MRS features in chronic hepatits C and HIV/HCV coinfected patients.

Methods: Liver in vivo 1H MR spectra were obtained in 48 patients: 14 with chronic hepatitis C, 20 coinfected HIV/HCV, and 24 healthy volunteers. Resonances of lipids, glutamine/glutamate (Glx), phosphomonoesters (PME), glycogen/glucose (Glc) were assesses and metabolite ratios to total lipids (TL) were calculated.

Results: Significant increase in Glx/TL (0.017±0.005 v. 0.042±0/007, p<0.01) and PME/TL (0.112±0.031 v. 0.024±0.006, p<0.01) was observed in chronic hepatitis C patients compared to healthy individuals. HIV and HCV coinfection resulted in further increase of all metabolite ratios (Glx/TL: 0.078±0.02; PME/TL: 0.173±0.033), which superseded values obtained not only in controls (p<0.05 and p<0.001 respectively) but also those in chronic hepatitis C (p<0.01). Changes in metabolite ratios were due to both the increase in particular metabolite contents and the decrease in lipid levels. Furthermore HIV/HCV-infected patients undergoing HAART showed elevated PME and Glx levels and significantly decreased TL amount compared to patients without antiretroviral treatment. Further alterations in liver metabolites content was observed in patients with lipodystrophy syndrome symptoms. Those patients presented additional increase of PME and TL.

Conclusions: Our finding suggest clinical usefulness of liver 1H MR spectroscopy in detecting even slight disturbances in liver metabolism despite the lack of other markers of liver injury and regeneration in HIV/HCV coinfected patients.

Presenting Author: MD. PhD Alicja Wiercinñska-Drapalo, Department of Infectious Diseases, Medical University of Bialystok, Zurawia 14, 15-540, Bialystok, Poland, Phone: +48 85 7416 921

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