Liver disease is frequently seen in HIV-positive patients as a result of coinfection with Hepatitis B or Hepatitis C viruses, alcohol abuse and/or exposure to hepatotoxic drugs.
|Hepatitis C virus was found in 82% of patients|
|Journal of Viral Hepatitis|
Dr Castellares and colleagues from Madrid assessed the prevalence of liver cirrhosis, its main causes and clinical presentation in HIV-positive patients.
The research team conducted an observational, cross-sectional, retrospective study of all HIV-positive individuals followed at 1 reference HIV outpatient clinic in Madrid.
The team measured liver fibrosis in all cases using transient elastometry.
All 2168 HIV-positive patients on regular follow-up were successfully examined between 2004 and 2006.
The team recognized liver cirrhosis in 181 patients, an overall prevalence of 8%.
The main etiologies included Hepatitis C virus infection in 82%, and Hepatitis B virus in 2%.
In addition, the team noted that dual Hepatitis B virus/Hepatitis C virus occurred in 3%.
Triple Hepatitis B virus/Hepatitis C virus/Hepatitis delta virus infection was found in 7%.
The researchers found that the prevalence of cirrhosis differed among patients with distinct chronic viral hepatitis.
Hepatitis C virus occurred in 19%, Hepatitis B virus in 6%, and Hepatitis B virus/Hepatitis C virus in 42% of patients with distinct chronic viral hepatitis.
The team observed that triple Hepatitis B virus/Hepatitis C virus/Hepatitis delta virus infection was the cause of chronic viral hepatitis in 67%.
In 7% of patients with cirrhosis, no definite etiology was recognized.
The team found that overall, cirrhotics had lower mean CD4 counts than noncirrhotics.
The research team noted the lower CD4 count despite similar proportion of subjects with undetectable viremia on highly active antiretroviral therapy.
The team found clinical manifestations of liver cirrhosis included splenomegaly, esophageal varices, ascites, encephalopathy, and variceal bleeding.
Dr Castellares' team concluded, "Liver cirrhosis and hepatic decompensation events are relatively frequent in HIV-positive individuals."
"Chronic Hepatitis C virus and alcohol abuse, but not chronic Hepatitis B virus, play a major role."
"Transient elastometry may allow the identification of a significant number of HIV-positive individuals with asymptomatic liver cirrhosis."