Hepatic steatosis in HIV–HCV coinfected patients: analysis of risk factors

Bani‐Sadr, Firouzé; Carrat, Fabrice; Bédossa, Pierre; Piroth, Lionel; Cacoub, Patrice; Perronne, Christian; Degott, Claude; Pol, Stanislas

doi:10.1097/01.aids.0000210606.63138.f5

Cited by 81 publications

(100 citation statements)

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“…BMI, assessed in four studies, 22,23,25,26 was associated with an increased risk for HS; however, with small magnitude (pooled OR 1.13, 95% CI 1.07-1.19, P < 0.001) (Fig. 2).…”

Section: Resultsmentioning

confidence: 97%

“…Twelve studies were included [19][20][21][22][23][24][25][26][27][28][29][30] addressing a total of 1,989 HIV/HCV-coinfected patients. In four of these studies 20,24,25,28 data regarding HCV-monoinfected patients were presented separately, with a total of 1,540 patients.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies 23,27 were subanalyses of major controlled randomized trials of HCV anti-viral treatment in coinfected populations, namely, the ANRS HC02 31 and APRICOT trials. 32 In these trials HIV infection was required to be stable, with good immune system status and under no ART or on a stable schedule for the 3 months preceding the study.…”

Section: Resultsmentioning

confidence: 99%

“…All of them required patients to be HCV treatment-naives and negative for hepatitis B surface antigen. Except for significant alcohol consumption, greater than 40-50 g per day, which was an exclusion criterion in only five studies, [23][24][25]27,28 other causes of liver disease were systematically excluded. Liver biopsies with less than 10 mm length were considered as an exclusion criterion in just two studies.…”

Section: Resultsmentioning

confidence: 99%

“…33 Two studies 25,26 used the chronic hepatitis C validated METAVIR classification system, 34 in which steatosis is considered mild if present in 1%-10% of the hepatocytes, moderate in 11%-30%, and severe when in more than 30%. Necroinflammation and fibrosis were graded or staged by METAVIR 20,21,23,25,26 or Ishak classifications. 35 Steatosis Prevalence.…”

Section: Resultsmentioning

confidence: 99%

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Hepatic Steatosis in Patients Coinfected with Human Immunodeficiency Virus/Hepatitis C Virus: A Meta-Analysis of the Risk Factors

2010

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Hepatic steatosis (HS) is frequent in patients with hepatitis C virus (HCV) infection, occurring in 40%-80%, associating with metabolic and virus-related factors, namely, genotype 3 and viral load. Human immunodeficiency virus (HIV) infection and antiretroviral treatment seem to be risk factors for HS. Several studies addressed this issue in coinfected patients, with discrepant results. A meta-analysis was performed on the HS risk factors in coinfected patients. Eligible studies were identified through structured keywords including coinfection, HCV, HIV, and steatosis in relevant databases including PubMed. Pooled odds ratios (ORs) and confidence limits (CIs) were obtained with the random-effects model and the DerSimonian-Laird method. Twelve studies, including 1,989 coinfected patients, were selected. Twenty percent were infected with HCV genotype 3. The overall prevalence of HS was 50.8% (23%-72%). Four studies also included 1,540 HCV monoinfected patients, not showing an increased risk for HS in coinfected patients (OR 1.61, 95% CI 0.84-3.10, P 5 0.151). In coinfected patients, HS was associated with higher body mass index (OR 1.13, 95% CI 1.07-1.19, P < 0.001), diabetes mellitus (OR 2.32, 95% CI 1.32-4.07, P 5 0.003), elevated alanine aminotransferase levels (OR 1.28, 95% CI 1.02-1.61, P 5 0.035), necroinflammatory activity (OR 1.72, 95% CI 1.11-2.67, P 5 0.016), and fibrosis (OR 1.67, 95% CI 1.20-2.34, P 5 0.003). No associations were found between HS and gender, other metabolic factors (dyslipidemia, glucose, metabolic syndrome), HCV-related factors (genotype, viral load), or HIV-related factors (viral load, CD4 count, antiretroviral therapy, and class of medication). Conclusion: In coinfected patients, HS does not seem to be more frequent than in HCV monoinfected patients and is mostly associated with metabolic factors, such as increased weight, diabetes mellitus, and more severe liver disease. The fact that no associations with HCV factors were found may be due to the small percentage of genotype 3-infected patients. (HEPATOLOGY 2010;52:71-78)

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“…BMI, assessed in four studies, 22,23,25,26 was associated with an increased risk for HS; however, with small magnitude (pooled OR 1.13, 95% CI 1.07-1.19, P < 0.001) (Fig. 2).…”

Section: Resultsmentioning

confidence: 97%