Factors influencing liver fibrosis and necroinflammation in HIV/HCV coinfection and HCV monoinfection

"OBJECTIVES: To define differences in liver histology between HIV\/HCV coinfection . and HCV monoinfection, and to investigate possible causative factors.. METHODS: Liver biopsies (LBs) from 440 consecutive HIV\/HCV-coinfected patients. (Group HIV\/HCV) and 374 consecutive HCV-monoinfected patients (Group HCV) were. evaluated for necroinflammation and fibrosis (Ishak) by a pathologist unaware of . the clinical and laboratory data. All patients were HBsAg-negative, with no. history of alcohol abuse and naïve to anti-HCV treatment. At LB, 78.4% of. patients in Group HIV\/HCV were on an antiretroviral regimen.. RESULTS: HIV\/HCV-coinfected patients compared to the HCV-monoinfected patients. were younger (p < 0.0001), more frequently males (p < 0.0001), and had HCV. genotype 3 (p < 0.0001); they showed a good immunological condition (CD4+ cell. count: 518 ± 166 cells\/mm(3)). Patients in Group HIV\/HCV more frequently showed a. fibrosis score ≥4 (27.5 vs. 20.6%, p < 0.05) and a necroinflammation score ≥9. (25.9 vs. 13.4%; p < 0.0001). The prevalence of patients with fibrosis score ≥4. was significantly higher in older age classes in both Group HIV\/HCV (p < 0.005). and Group HCV (p < 0.05). A necroinflammation score ≥9 was significantly higher. in older age classes only in Group HIV\/HCV (p < 0.05). A multivariate analysis. for Group HIV\/HCV revealed that the patient age and nadir of CD4+ cell count were. independently associated to higher degrees of fibrosis, the patient age and. antiretroviral treatment were associated to higher degrees of necroinflammation, . and HCV genotype 3 was associated to higher degrees of steatosis.. CONCLUSION: The data suggest a need for early anti-HCV treatment in both. HCV-monoinfected and HIV\/HCV-coinfected patients."