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News

HIV, age, and the severity of Hepatitis C virus–related liver disease

A study in the latest issue of the Annals of Internal Medicine investigates the influence of HIV, and age on the severity of Hepatitis C virus–related liver disease.

News image

Persons with HIV infection have been reported to develop age-related diseases at younger ages than those without HIV.

Whether this finding is related to HIV infection or failure to control for other risk factors is unknown.

Dr Gregory Kirk from Maryland, USA investigated whether persons with HIV infection develop hepatitis C virus–related liver disease at younger ages than similar persons without HIV.

Comparison of the severity of liver fibrosis by age among persons who have Hepatitis C virus with and without HIV followed concurrently in the same protocol.

The researchers identified 1176 current, and former injection drug users with antibodies to hepatitis C virus.

Liver fibrosis was assessed semiannually from 2006 to 2011 by elastography and using previously validated thresholds for clinically significant fibrosis and cirrhosis.

The team performed a concurrent assessment of medical history, alcohol and illicit drug use, hepatitis C virus RNA levels, hepatitis B virus surface antigen level, body mass index, and CD4+ lymphocyte count and HIV RNA levels.

The team of doctors found that among 1176 participants with antibodies to hepatitis C virus, the median age was 49 years, and 34% were coinfected with HIV and hepatitis C virus.

Participants contributed 5634 valid liver fibrosis measurements.

34% were coinfected with HIV and hepatitis C virus
Annals of Internal Medicine

The research team examined that the prevalence of clinically significant fibrosis without cirrhosis, and of cirrhosis was greater in persons coinfected with HIV and hepatitis C virus than in those with only hepatitis C virus.

Increasing age and HIV infection were independently associated with liver fibrosis, as were daily alcohol use, chronic hepatitis B virus infection, body mass index greater than 25 kg/m2, and greater plasma hepatitis C virus RNA levels.

The team of doctor reported that when these factors were kept constant, persons with HIV had liver fibrosis measurements equal to those of persons without HIV, who were, on average, 9 years older.

The process of liver fibrosis began before the study in most persons.

Dr Kirk's team commented "In this cohort, persons who have hepatitis C virus with HIV have liver fibrosis stages similar to those without HIV who are nearly a decade older."

Ann Intern Med 2013; 158(9): 658-666
09 May 2013

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