Progression of Liver Fibrosis in Monoinfected Patients by Hepatitis C Virus and Coinfected by HCV and Human Immunodeficiency Virus

Tovo, Cristiane Valle; Becker, Smile Calisto da Costa; Almeida, Paulo Roberto Lerias de; Galperim, Bruno; Chaves, Silvia Clelia

doi:10.1590/s0004-28032013000100005

Cited by 12 publications

(9 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…51 Chronic HCV infection is more likely in HIV patients and this is associated with higher HCV viral loads. 51 Coinfected patients demonstrate a faster progression to cirrhosis and end-stage liver disease though this may be attenuated by early HAART where available, 52-54 and historically responded less well to interferon and ribavirin treatment regimens. 55 However, attempting treatment remains important as achieving a sustained virological response dramatically reduces the incidence of liver-related morbidity and mortality in this population.…”

Section: Introductionmentioning

confidence: 99%

Hepatitis C

Webster¹,

Klenerman²,

Dusheiko³

2015

The Lancet

445

348

View full text Add to dashboard Cite

Hepatitis C virus (HCV) infection is a major global health problem that continues to grow with an estimated 170 million people infected. The consequences of chronic infection can include cirrhosis, end-stage liver disease and hepatocellular carcinoma. Due to shared routes of transmission, coinfection with HIV is a significant problem and individuals infected with both viruses have poorer outcomes. There is no effective vaccine though HCVis a potentially curable persistent viral infection. For many years, the standard of care has been subcutaneous interferon-alpha and oral ribavirin for between 24 and 72 weeks of treatment. This treatment results in a sustained virological response in only about 50% of individuals and is complicated by significant adverse events. In recent years, advances in HCV cell culture has allowed a greater understanding of HCV virology and this has paved the way for the development of many new directly acting antiviral drugs that target key components of virus replication such as protease and polymerase inhibitors. We are now at a point of improved and simplified treatments for HCV that may be administered as oral regimens of short duration and with far greater tolerability than regimens of old. The remaining hurdles may be access to appropriate care and cost of treatment as the epidemic continues to grow.

show abstract

Section: Introductionmentioning

confidence: 99%

Hepatitis C

Webster¹,

Klenerman²,

Dusheiko³

2015

The Lancet

445

348

View full text Add to dashboard Cite

show abstract

“…Liver-related disease including chronic viral hepatitis now accounts for 13-18 % of all-cause mortality in HIV-infected patients and is one of the leading causes of non-AIDS-related death, competing closely with non-AIDS-related can-cer [2,3,9]. In the HCV/HIV co-infected population, HIV is known to accelerate the natural history of liver disease, with coinfected individuals demonstrating accelerated progression to hepatic fibrosis, cirrhosis, and increased risk for hepatocellular carcinoma [10][11][12]. More recently, data from the CFAR Network of Integrated Clinical Systems (CNICS) study cohort demonstrates that poorly controlled HIV mono-infection is an independent risk factor for liver fibrosis [13].…”

Section: Introductionmentioning

confidence: 99%

Aging of the Liver: What This Means for Patients with HIV

Chan

Patel

2016

Curr HIV/AIDS Rep

View full text Add to dashboard Cite

As the HIV population continues to live longer as a result of antiretroviral therapy, liver-related mortality has become one of the leading causes of non-AIDS related death in this patient population. The liver possesses a remarkable regenerative capacity but undergoes complex biological changes in response to aging and inflammation that result in decreased cellular regeneration and a tipping of the scales towards fibrogenesis. Patients with HIV infection have serological evidence of ongoing inflammation, with elevations in some biomarkers persisting despite adequate virologic control. In addition, HIV-co-infected patients have markers of advanced age on liver biopsy and increased prevalence of fibrosis as compared to an age-matched HCV mono-infected cohort. In this review, we will discuss the biology of aging, age-related changes in the liver, and the relevant mechanisms by which HIV causes inflammation in the context of accelerated aging, fibrosis of the liver, and other viral co-infection.

show abstract

“…Tovo et al(94) andSterling et al (92) were longitudinal in nature while all others were cross-sectional. Unfortunately, in both former studies the interval between biopsies was shorter for the HIV/HCV coinfected compared to the HCV monoinfected patients.…”

mentioning

confidence: 99%