Assessment of liver cirrhosis by elastography in HCV/HIV co-infected patients

Abstract number: 1733_1395

Castellares C., Martín-Carbonero L., Barreiro P., Ramos B., Sheldon J., Labarga P., Novoa-Rodríguez S., González-Lahoz J., Soriano V.

Introduction: Chronic hepatitis C is now one of the leading causes of morbidity and mortality among HIV-infected individuals. The evaluation of liver injury in HIV/HCV co-infected patients should follow the same principles as monoinfected ones.

Methods: Retrospective analysis of all HCV/HIV co-infected patients in our institution assessed by FibroScan since Oct 2004 to June 06. Patients with F4 METAVIR fibrosis score estimates (>12.5 kPa) by elastography (FibroScan) were compared to patients without liver cirrhosis.

Results: A total of 772 HIV/HCV co-infected patients were examined, 20% of whom had F4. The mean liver stiffness in them was 25.7 kPa. Overall, 42% of cirrhotics admitted current and/or past alcohol abuse. Their distribution according to Child-Pugh score was: A 68%, B 28% and C 4%. Plasma HIV RNA was undetectable in 67% of cirrhotics and 62% of the rest [p = NS], and CD4 counts <200 cells/mL were present in 27% of cirrhotics vs. 12% of the rest [p < 0.01]. Overall, 25% of patients who had received HCV treatment showed liver fibrosis improvement. During the study period, mortality was 16.5% in cirrhotics.

Conclusions: liver cirrhosis is quite prevalent in HCV/HIV-coinfected patients. Transient elastography may help to recognize subclinical cirrhosis and design more appropriate therapeutic and prophylactic strategies for this population.