BACKGROUND: Liver fibrosis requiring treatment in HIV/hepatitis C virus (HCV)-coinfected patients with persistently normal alanine aminotransferase (ALT) values (PNAL) is currently not well defined; in this study clinical and histologic features of PNAL were compared with those of subjects with elevated ALT (EAL). METHODS: A total of 326 liver biopsies of HIV/HCV-coinfected patients, performed from 1997-2003, were retrospectively identified. Subjects with at least 3 consecutive normal ALT determinations during a prebiopsy follow-up of 12 months were grouped as PNAL (24 patients) and compared with EAL subjects (302 patients). Liver biopsy was classified with the modified Ishak score. RESULTS: Age, HCV viral load, and genotype, CD4 T-cell count, and antiretroviral drugs did not show a statistical difference between the 2 groups. Statistical significance was found when comparing mean grading (1.4 +/- 1.8 vs. 7.2 +/- 2.6, P < 0.0001) and staging (1.4 +/- 1.79 vs. 2.5 +/- 1.7, P < 0.0003) between PNAL and EAL subjects. The proportion of PNAL patients fulfilling histologic criteria for anti-HCV treatment (25% with stage 2-6) was also significantly different from EAL subjects (69%; P = 0.0001). At multivariate analysis, only age, CD4 count (>500 vs. < or =500 cells/mL), and patient's group (EAL vs. PNAL) were found to be independently associated with a fibrosis score of > or =2. CONCLUSION: Liver fibrosis requiring treatment was found in 25% of HIV/HCV-coinfected subjects with PNAL values.
BACKGROUND:Liver fibrosis requiring treatment in HIV/hepatitis C virus (HCV)-coinfectedpatients with persistently normal alanine aminotransferase (ALT) values (PNAL) is currently not well defined; in this study clinical and histologic features of PNAL were compared with those of subjects with elevated ALT (EAL). METHODS: A total of 326 liver biopsies of HIV/HCV-coinfectedpatients, performed from 1997-2003, were retrospectively identified. Subjects with at least 3 consecutive normal ALT determinations during a prebiopsy follow-up of 12 months were grouped as PNAL (24 patients) and compared with EAL subjects (302 patients). Liver biopsy was classified with the modified Ishak score. RESULTS: Age, HCV viral load, and genotype, CD4 T-cell count, and antiretroviral drugs did not show a statistical difference between the 2 groups. Statistical significance was found when comparing mean grading (1.4 +/- 1.8 vs. 7.2 +/- 2.6, P < 0.0001) and staging (1.4 +/- 1.79 vs. 2.5 +/- 1.7, P < 0.0003) between PNAL and EAL subjects. The proportion of PNAL patients fulfilling histologic criteria for anti-HCV treatment (25% with stage 2-6) was also significantly different from EAL subjects (69%; P = 0.0001). At multivariate analysis, only age, CD4 count (>500 vs. < or =500 cells/mL), and patient's group (EAL vs. PNAL) were found to be independently associated with a fibrosis score of > or =2. CONCLUSION:Liver fibrosis requiring treatment was found in 25% of HIV/HCV-coinfected subjects with PNAL values.
Authors: Mark Hull; Pierre Giguère; Marina Klein; Stephen Shafran; Alice Tseng; Pierre Côté; Marc Poliquin; Curtis Cooper Journal: Can J Infect Dis Med Microbiol Date: 2014 Impact factor: 2.471
Authors: C Sagnelli; C Uberti-Foppa; G Pasquale; S De Pascalis; N Coppola; L Albarello; C Doglioni; A Lazzarin; E Sagnelli Journal: Infection Date: 2013-07-10 Impact factor: 3.553
Authors: Mark Hull; Marina Klein; Stephen Shafran; Alice Tseng; Pierre Giguère; Pierre Côté; Marc Poliquin; Curtis Cooper Journal: Can J Infect Dis Med Microbiol Date: 2013 Impact factor: 2.471
Authors: Mark Hull; Stephen Shafran; Alex Wong; Alice Tseng; Pierre Giguère; Lisa Barrett; Shariq Haider; Brian Conway; Marina Klein; Curtis Cooper Journal: Can J Infect Dis Med Microbiol Date: 2016-07-04 Impact factor: 2.471