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Barbara H. McGovern, Jeremy S. Ditelberg, Lynn E. Taylor, Rajesh T. Gandhi, Katerina A. Christopoulos, Stacey Chapman, Beth Schwartzapfel, Emily Rindler, Anne-Marie Fiorino, M. Tauheed Zaman, Paul E. Sax, Fiona Graeme-Cook, Patricia L. Hibberd, Hepatic Steatosis Is Associated with Fibrosis, Nucleoside Analogue Use, and Hepatitis C Virus Genotype 3 Infection in HIV-Seropositive Patients, Clinical Infectious Diseases, Volume 43, Issue 3, 1 August 2006, Pages 365–372, https://doi.org/10.1086/505495
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Abstract
Background. We conducted a study to determine the prevalence and factors associated with hepatic steatosis in human immunodeficiency virus (HIV)—seropositive patients with hepatitis C and to investigate whether steatosis is associated with liver fibrosis.
Methods. Retrospective chart reviews were conducted in 4 hospitals that serve community-based and incarcerated HIV-infected patients who had undergone a liver biopsy for evaluation of hepatitis C virus (HCV) infection during the period of 2000–2003. Demographic characteristics and medication and laboratory data were collected from the time of the biopsy. A pathologist blinded to all clinical data evaluated the specimens. The primary outcome was presence or absence of steatosis.
Results. of 260 HIV-HCV—coinfected patients, 183 met inclusion criteria and had a biopsy specimen adequate for review. Steatosis was present in 69% of patients (graded as minimal in 31%, mild in 27%, moderate in 18%, and severe in 1%). Factors associated with steatosis included use of dideoxynucleoside analogues, such as didanosine and stavudine (odds ratio [OR], 4.63; 95% confidence interval [CI], 1.55–13.82). There was a trend toward presence of steatosis and use of other nucleoside analogues or infection with HCV genotype 3 (OR, 2.65 [95% CI, 0.95–7.41] and 3.38 [95% CI, 0.86–13.28], respectively). The presence of steatosis was associated with fibrosis (OR, 1.37; 95% CI, 1.03–1.81).
Conclusions. In this multiracial population of HIV-HCV—coinfected patients, steatosis was prevalent and was associated with severity of liver fibrosis. Use of nucleoside analogues (particularly didanosine and stavudine) and HCV genotype 3 infection were associated with hepatic steatosis. The development of steatosis is multifactorial in nature and may play a contributory role in the progression of liver disease in HIV-infected patients.
- hiv
- liver diseases
- biopsy
- didanosine
- fatty liver
- fibrosis
- hepatic fibrosis
- hepatitis c
- demography
- dideoxynucleosides
- hiv seropositivity
- stavudine
- infections
- liver biopsy
- nucleoside analog
- hiv infections
- hepatitis c virus
- community
- nucleoside analog antiviral
- fatty degeneration
- hepatitis c virus genotype 3
