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Researchers found that HIV infection
promotes the progression of liver disease in people coinfected with the
hepatitis C virus (HCV). David Thomas, MD, of Johns Hopkins School of Medicine
and colleagues conducted a prospective observational study in a cohort of
HCV-infected people. The researchers were aware that although people with HIV
have been reported to develop age-related disease at a younger age, it has not
been determined whether the observations are caused by HIV infection or other
risk factors.
The researchers used data from the
AIDS Linked to the IntraVenous Experience (ALIVE) cohort of current and former
injection drug users in Baltimore. They compared liver fibrosis severity by age
(assessed every six months by liver stiffness measurements) among HCV-infected
individuals with and without HIV who were being followed up over time with the
same protocol.
Of the 1,176 participants (median
age of 49 years), 34 percent were coinfected with HIV. Participants had 5,634
liver fibrosis measurements throughout 2.9 years of follow-up. Individuals with
both HCV and HIV infection had significantly more cirrhosis or clinically
significant fibrosis without cirrhosis at the beginning of the study. Liver
fibrosis was independently associated with older age and HIV infection. Using a
multivariate model, researchers calculated the expected liver fibrosis value by
age and found that, with age held constant, fibrosis was 1.17 to 2.02
kilopascals greater in individuals with HIV than those without. This means that
HIV-infected people had liver fibrosis measurements equal to those of
uninfected individuals approximately 9.2 year older. Also, liver fibrosis among
HIV-infected individuals was associated with lower nadir or current counts of
CD4-positive T cells and with higher levels of HIV RNA.
The full report, “HIV, Age, and the
Severity of Hepatitis C Virus–Related Liver Disease: A Cohort Study,” was
published online in the journal Annals of Internal Medicine (February 26,
2013).
The Friends of AIDS Foundation is
dedicated to enhancing the quality of life for HIV positive individuals and
empowering people to make healthy choices to prevent the spread of the HIV
virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.
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