Liver Fibrosis Progression Is Related to CD4 Cell Depletion in Patients Coinfected with Hepatitis C Virus and Human Immunodeficiency Virus

Abstract

A total of 204 patients with liver biopsy-proven hepatitis C virus (HCV) infection, 84 with and 120 without human immunodeficiency virus (HIV) coinfection, were studied, to evaluate variables possibly associated with the stage of liver fibrosis. All patients were injection drugs users, with a mean age of 32 years and an estimated duration of HCV infection of 12 years. Twenty-four patients (11%) had many fibrous septa with (5%) or without (6%) cirrhosis, 56 (27%) had few fibrous septa, and 124 (60%) had no fibrous septa. In all patients, an association was found between CD4 cell counts <500 cells/mm(3)and the presence of many fibrous septa (odds ratio, 3.2; P=.037), independent of HIV infection and other factors. These results suggest that HIV infection-induced CD4 depletion is independently associated with the severity of liver fibrosis in chronic HCV infection.

Hepatitis C Virus and HIV Envelope Proteins Collaboratively Mediate Interleukin-8 Secretion through Activation of p38 MAP Kinase and SHP2 in Hepatocytes

“…The more rapid progression of hepatic disease with co-infection is currently unexplained. It has also been shown that co-infected patients have a higher incidence of fibrosis (6,7). Furthermore, a greater degree of portal, periportal, and lobular inflammation (centrilobular fibrosis, cholestasis, and granulocytic cholangiolitis) was reported in patients with HCV/HIV co-infection than with HCV alone (8).…”

HAART and the HCV-infected liver: friend or foe?

“…CD4 cell count , 200 mm 3 ) has been independently associated with an increased risk of advanced histologic and/or clinical liver disease in persons coinfected with HIV and hepatitis C [6,9,19,20]. This inverse relationship of CD4 cell count and liver disease supports the hypothesis that reversal or prevention of immunosuppression with HAART will decrease the rate of HCV fibrosis progression and the risk of cirrhosis and its clinical consequences (ESLD, hepatocellular carcinoma and death) in HIV-infected patients.…”

HIV Prevalence among HCV Egyptian Infected Patients and Its Impact on the Result of HCV Treatment

“…HCV is not directly cytopathic and the pathogenesis of liver injury is believed to be immune mediated [21]. It can be argued that HIV patients should develop less severe liver injury because of the immune suppression [22].…”

“…Individuals infected with HCV genotype 2, 3 have better response than HCV genotypes 1, 4 "like the situation in Egypt, where genotype 4 is predominant" [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. Also the number of HIV patients included in our study was too small to draw definitive conclusions.…”