Article

Association of HIV infection, HCV infection and Metabolic Factors with Liver Stiffness measured by Transient Elastography.

Department of Medicine, University of California, San Francisco, 94122, USA.
The Journal of Infectious Diseases (Impact Factor: 5.78). 07/2013; DOI: 10.1093/infdis/jit357
Source: PubMed

ABSTRACT Background. Few studies have examined the relationship of HIV monoinfection and its associated perturbations with liver fibrosis.Methods. Using multivariable linear regression, we examined the demographic, behavioral, metabolic and viral factors associated with transient elastography-measured liver stiffness (LS) in 314 participants (165 HIV+/HCV-,78 HIV+/HCV+,14 HIV-/HCV+,57 HIV-/HCV-) of the Women's Interagency HIV Study.Results. Compared to HIV-/HCV- women, HIV+/HCV+ women had greater median LS values (7.1 vs. 4.4 kPa;p<0.0001); HIV+/HCV- and HIV-/HCV- women had similar LS (both 4.4 kPa;p=0.94). HIV/HCV coinfection remained associated with greater LS (74%, 95% confidence interval [CI]:49,104) even after multivariable adjustment. Among HCV+ women, waist circumference (WC) (per 10 cm increase) was associated with an 18% (95%CI:7.5,30) greater LS after multivariable adjustment; WC showed little association among HIV+/HCV- or HIV-/HCV- women. Among HIV+/HCV- women, history of AIDS (13%;95%CI:0.4,27) and HIV RNA (7.3%;95%CI:1.59,13.3, per 10-fold increase) were associated with greater LS.Conclusions. HCV infection but not HIV infection is associated with greater LS when compared to women with neither infection. Our finding that WC, a marker of central obesity, is associated with greater LS in HIV/HCV-coinfected but not HIV-monoinfected or women with neither infection suggests that in the absence of HCV-associated liver injury the adverse effects of obesity are lessened.

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