Hepatic steatosis has been reported in human immunodeficiency virus(HIV) /hepatitis C virus coinfection.
However, the features of steatohepatitis, including cytologic ballooning and pericellular fibrosis, its risk factors, and the impact on disease severity in such patients are unknown.
|33% had bridging fibrosis or cirrhosis|
Dr Richard Sterling and colleagues from Virginia, USA assessed liver histology in consecutive coinfected patients.
The research team defined the prevalence and severity of the features of steatohepatitis, its risk factors, and its impact on the severity of liver disease.
The team studied a total of 222 subjects, of which 74% were male with a mean age of 45, 78% were African American, and 90% were genotype 1.
The mean body mass index was 26, and 18% had a body mass index over 30.
The team found that the prevalence of risk factors for steatosis was 31% with diabetes, 15% with hypertension, and 8% with dyslipidemia.
The prevalence of metabolic syndrome was 9%, and alcohol abuse in 21%.
Steatosis was present in 23%, and steatohepatitis was present in 17%.
The team found the steatosis was mild in 19%, and moderate to severe in 4%.
Cytologic ballooning and pericellular fibrosis were present in 30% and 13%, respectively.
The mean Ishak score was 7, and 33% had bridging fibrosis or cirrhosis.
Both steatosis and cytologic ballooning were associated with body mass index, metabolic syndrome, and insulin resistance.
The research team found that the presence of either steatosis and cytologic ballooning was strongly associated with advanced fibrosis.
Diabetes, and genotype 3 with steatosis, diabetes with cytologic ballooning, and longer duration of infection with steatohepatitis were associated with increased body mass index.
Dr Sterling's team concluded, "Steatosis and steatohepatitis are present in 23% and 30%, respectively, of patients with human immunodeficiency virus /Hepatitis C virus coinfection."
"Both are associated with an increased risk of having advanced fibrosis."
"Although we identified genotype 3, increased body mass index, and diabetes as risk factors, we found no independent association with antiretroviral therapy.