Impact of human immunodeficiency virus infection on the histological features of chronic hepatitis C: A case-control study

Hepatitis C virus (HCV) is frequently encountered in human immunodeficiency virus (HIV)-infected patients because of common routes of transmission. Previous studies suggested that HIV infection impaired the natural course of chronic hepatitis C, with a more rapid progression to cirrhosis. However, these studies did not assess the HIV infection impact on chronic hepatitis C by taking into account the risk factors for liver fibrosis progression: alcohol, sex, age at the contamination, and duration of HCV infection. We studied liver biopsy specimens of 2 groups of 58 patients that were infected by both HCV and HIV or by HCV alone. The 2 groups were matched according those risk factors, and liver biopsy responses were evaluated with the METAVIR items. The METAVIR activity was higher in HN-positive than HIV-negative patients. Cirrhosis was more frequent: (1) in HIV-positive patients with CD4 less than or equal to 200 cells/mu L (45%) than in HIV-negative patients (10%) (P =.003), (2) in HIV-positive patients with CD4 less than or equal to 200 cells/mu L (45%) than in HIV-positive patients with CD4 > 200 cells/mu L (17%) (P =.04). These differences, which were linked to HIV status, might be related to the enhanced HCV replication during HIV infection or other immune mechanisms that need further studies. HUM PATHOL 31:69-74, Copyright (C) 2000 by W.B. Saunders Company.