Fibrosis Progression in Human Immunodeficiency Virus and Hepatitis C Virus
October 1999, p. 1054-1058, Vol. 30, No. 4
Benhamou1, Marie Bochet2, Vincent Di Martino1, Frederic Charlotte3,
the 1Service d'H╚pato-Gastroent╚rologie, Groupe Hospitalier Piti╚ Salp═tri╦re
and UPRES-A 8067, Paris, France; 2Service de Maladies Infectieuses,
Groupe Hospitalier Piti╚-Salp═tri╦re, Paris, France; 3 Service d'Anatomie
Pathologique, Groupe Hospitalier Piti╚-Salp═tri╦re, Paris, France; and
4Service de M╚decine Interne, Groupe Hospitalier Piti╚-Salp═tri╦re,
natural history of hepatitis C virus (HCV) infection in human
virus (HIV)-infected patients has never been studied according to the concept of liver fibrosis progression. The
aim of this work was to assess the
fibrosis progression rate in HIV-HCV coinfected patients and in patients
infected by HCV only. A cohort of 122 HIV-HCV coinfected patients was
compared with a control group of 122 HIV-negative HCV-infected patients.
Groups were matched according to age, sex, daily alcohol consumption, age at HCV
infection, and duration and route of HCV infection. The fibrosis progression
rate was defined as the ratio between fibrosis stage (METAVIR scoring system)
and the HCV duration. The prevalence of extensive liver fibrosis (METAVIR
fibrosis scores 2, 3, and 4) and moderate or severe activity were
higher in HIV-infected patients (60% and 54%, respectively) than in control
patients (47% and 30%, respectively; P < .05 and
P < .001, respectively).
The median fibrosis progression rate in coinfected patients and in control
patients was 0.153 (95% confidence interval [CI], 0.117-0.181) and 0.106 (95%
CI, 0.084-0.125) fibrosis units per year, respectively (P < .0001).
HIV seropositivity (P < .0001),
alcohol consumption (>50 g/d, P = .0002),
age at HCV infection (<25 years old, P < .0001), and severe immunosuppression (CD4 count 200
cells/ÁL, P < .0001)
were associated with an increase in the fibrosis progression rate. In coinfected
patients, alcohol consumption (>50 g/d), CD4 count (200 cells/ÁL), and age
at HCV infection (<25 years old) (P < .0001, respectively) were associated with a
progression rate. HIV seropositivity accelerates HCV-related liver fibrosis progression. In coinfected patients, a low CD4 count, alcohol consumption rate, and age at HCV infection are associated with a higher liver fibrosis progression rate.