Having HIV is not linked to the progression of liver fibrosis, or scarring, among those with hepatitis C virus (HCV), aidsmap reports.
Publishing their findings in the Journal of Infectious Diseases, researchers conducted a study of 378 people with hep C, 31 percent of whom also had HIV (known as coinfection).
The findings of this study, which contrast prevailing belief, are buttressed by the study’s large sample size as well as the fact that its participants all had at least two liver biopsies conducted during the follow-up period, which ran from 1997 to 2013.
The researchers analyzed the results of 558 consecutive pairs of biopsies among the participants. On average, there was a seven-year gap between the first and last biopsies and a four-year spread between consecutive biopsies.
During the study’s follow-up period, 57 percent of individuals advanced at least one of the five fibrosis stages, F0 through F4. (F0 means no fibrosis; F4 is synonymous with cirrhosis.) Sixteen percent of the participants advanced two fibrosis stages; 7 percent developed cirrhosis.
After controlling the data for various factors, the researchers found that those who began the study with no fibrosis or mild fibrosis had a 13.51-fold increased likelihood of fibrosis advancement compared with those with more advanced fibrosis. Those who had at least one flare in their alanine aminotransferase (ALT) liver enzymes, meaning a test result above 200 units per liter, had a 2.64-fold increased likelihood of fibrosis progression.
The researchers theorized that the reason they did not identify HIV as a factor associated with the risk for fibrosis progression was that the participants were on successful treatment for that virus.
In an accompanying editorial, Daniel Fierer, MD, an associate professor of medicine and infectious disease specialist at Mount Sinai Hospital in New York City, wrote that there is still a concern about how HIV may accelerate liver damage among those with hep C. His research has found that men who have sex with men (MSM) who acquire HCV after contracting HIV are at high risk of rapid fibrosis advancement shortly after becoming coinfected. This suggests that contracting HCV after HIV poses a higher risk to fibrosis progression than acquiring the viruses in the reverse order.
To read the aidsmap article, click here.
To read the study abstract, click here. http://jid.oxfordjournals.org/content/early/2016/08/01/infdis.jiw332.abstract