Author/Authors :
Brescini, Lucia Polytechnic University of Marche - Clinical Infectious Diseases - Department of Biomedical Sciences and Public Health, Italy , Orsetti, Elena Polytechnic University of Marche - Clinical Infectious Diseases - Department of Biomedical Sciences and Public Health, Italy , Gesuita, Rosaria Polytechnic University of Marche - Centre for Epidemiology and Biostatistics, Italy , Piraccini, Francesca Polytechnic University of Marche - Centre for Epidemiology and Biostatistics, Italy , Marchionni, Elisa Polytechnic University of Marche - Clinical Infectious Diseases - Department of Biomedical Sciences and Public Health, Italy , Staffolani, Silvia Polytechnic University of Marche - Clinical Infectious Diseases - Department of Biomedical Sciences and Public Health, Italy , Castelli, Pamela Polytechnic University of Marche - Clinical Infectious Diseases - Department of Biomedical Sciences and Public Health, Italy , Drenaggi, Davide Polytechnic University of Marche - Clinical Infectious Diseases - Department of Biomedical Sciences and Public Health, Italy , Barchiesi, Francesco Polytechnic University of Marche - Clinical Infectious Diseases - Department of Biomedical Sciences and Public Health, Italy
Abstract :
Background: Due to the high efficacy of combination antiretroviral therapy (cART), the number of patients living with HIV is increasing. Chronic HCV infection has become a leading cause of non-AIDS related morbidity and mortality in patients with HIV infection. Objectives: The aim of this cross-sectional study was to identify factors associated with liver fibrosis (LF) in patients with HIV monoinfection and HIV-HCV coinfection. Patients and Methods: We analyzed LF by transient elastometry ([TE], Fibroscan) in three groups of patients (HIV, HIV-HCV and HCV) followed at the Infectious Diseases Department of University of Ancona, Italy, between October 2009 and November 2012. Results: In total, 354 adults including 98 HIV, 70 HIV-HCV and 186 HCV patients were studied. HIV-HCV patients had a longer duration of HIV (P 0.006) and HCV (P 0.001) infections. Additionally, they were receiving cART therapy for a longer period (P 0.001); they had higher prevalence of lipodystrophy (P 0.001) and higher HCV load (P = 0.004). LF was significantly more pronounced in HCV and HIV-HCV compared to HIV patients (P 0.001). A total of 13.3%, 39.2% and 51.4% of HIV, HCV and HIV-HCV, respectively, showed a LF ≥ F2. Additionally, a severe LF (F = 4) was significantly more frequent among HIV-HCV compared to other groups. A longer exposure to didanosine, stavudine, lopinavir/ritonavir and fosamprenavir resulted in increased LF by univariate analysis (P ranging from 0.001 to 0.007). By logistic regression analysis, the only variables significantly associated with increased LF were HCV coinfection, older age, and high AST values (P ranging from 0.001 to 0.036). Conclusions: HCV coinfection, older age and AST were associated with LF in patients with HIV infection.
