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Causative factors of liver fibrosis in HIV-infected patients. A single center study

Theodoros Androutsakos1, Maria Schina2, Abraham Pouliakis3

  • 1Department of Pathophysiology, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 115 27, Athens, Greece. T_Androutsakos@yahoo.gr.

BMC Gastroenterology
|April 8, 2020
PubMed

Insights

Hepatitis C virus (HCV) and Human Immunodeficiency virus (HIV) co-infection, older age, and alcohol abuse are key risk factors for liver fibrosis in HIV patients. Monitoring these factors is crucial for managing liver disease in this population.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Immunology

Background:

  • Liver disease is a major cause of illness and death in Human Immunodeficiency virus (HIV)-infected individuals.
  • Risk factors for liver disease in HIV patients are not well-established.
  • This study aimed to identify risk factors for liver fibrosis/cirrhosis in Greek HIV-infected patients.

Purpose of the Study:

  • To determine the risk factors associated with liver fibrosis and cirrhosis in a cohort of HIV-infected patients in Greece.
  • To identify specific clinical and laboratory parameters that correlate with liver fibrogenesis in this population.

Main Methods:

  • A cohort of 187 HIV-infected patients aged over 18 years was studied between December 2014 and December 2017.
  • Exclusion criteria included Body-Mass index (BMI) > 40, liver metastases, and prior chemotherapy.
  • Liver stiffness was measured using Vibration Controlled Transient Elastography (TE), and patients were categorized by fibrosis severity (Metavir score F0-F2 vs. F3-F4).

Main Results:

  • 92.5% of patients had mild or no liver fibrosis, while 7.4% had significant fibrosis.
  • Multivariate analysis revealed that older age, abnormal aspartate aminotransferase (AST) levels, Hepatitis C virus (HCV) infection, alcohol abuse, low CD4/CD8 ratio, and increased liver-related events (LREs) were significantly correlated with liver fibrosis/cirrhosis.

Conclusions:

  • Hepatitis C virus/HIV co-infection, older age, alcohol abuse, and CD4/CD8 ratio are associated with liver fibrogenesis in HIV-infected individuals.
  • These findings highlight the importance of managing co-infections and lifestyle factors in preventing liver disease progression in HIV patients.
Abstract

Keywords:
CD4/CD8 ratioHCV/HIV coinfectionHIV infectionLiver fibrosisLiver stiffnessTransient Elastography

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