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Alimentary Pharmacology & Therapeutics
Hepatic steatosis in HIV-HCV coinfected patients in France:
comparison with HCV monoinfected patients matched for body
mass index and HCV genotype
L. CASTÉRA*, , M.A.LOKOà, B.LEBAIL§,P.COFFIEà, V. DE LEDINGHEN*, P. TRIMOULET–,
M. WINNOCKà, F.DABISà, D. NEAU** & THE GROUPE D’EPIDÉMIOLOGIE CLINIQUE DU SIDA EN
AQUITAINE (GECSA) 1
*Department of Hepatology, Hôpital
Haut Lévêque, Centre Hospitalier
Universitaire (CHU) Bordeaux, Pessac,
France; Department of Hepatology,
Hopital St André, CHU Bordeaux,
Bordeaux, France; àINSERM U593
ISPED, Université Victor Segalen
Bordeaux-2, Bordeaux, France;
§Department of Pathology, Hôpital
Pellegrin, CHU Bordeaux, Bordeaux,
France; –Department of Virology,
Hôpital Pellegrin, CHU Bordeaux,
Bordeaux, France; **Department of
Infectious Diseases, Hôpital Pellegrin,
CHU Bordeaux; Bordeaux, France
Correspondence to:
Dr L. Castera, Service d’Hépato-
Gastroenterologie, C.H.U. de
Bordeaux, Hôpital Haut Lévêque,
Avenue Magellan, 33604 Pessac,
France.
E-mail: laurent.castera@
chu-bordeaux.fr
1 Composition of the GECSA in charge
of the ANRS CO3 Aquitaine Cohort is
presented in the Appendix.
Publication data
Submitted 26 July 2007
First decision 19 August 2007
Resubmitted 10 September 2007
Accepted 24 September 2007
SUMMARY
Background
Significance of steatosis in HIV-HCV coinfection remains controversial.
Aim
To compare the prevalence and predictors of hepatic steatosis between
HIV-HCV and HCV patients matched for steatosis known determinants.
Methods
A total of 564 HCV-naive patients undergoing liver biopsy were studied:
137 with HIV-HCV coinfection and 427 with HCV monoinfection,
among whom 137 were matched for age, gender, body mass index and
HCV genotype.
Results
Steatosis of any grade (67.1% vs. 41.6%, P < 0.0001), mixed steatosis
(55.4% vs. 21.1%, P < 0.0001), severe histological activity (A2-A3:
78.1% vs. 55.5%, P < 0.0001) and severe fibrosis (F3-F4: 33.1% vs.
15.3%, P < 0.0001) were significantly more common in coinfected than
in matched monoinfected patients. In multivariate analysis, steatosis
was associated only with severe histological activity [odds ratio (OR):
3.1 (95% CI: 1.3–7.1)] in coinfected patients and with elevated body
mass index [OR; 1.3 (1.1–1.5)], HCV genotype 3 [OR: 5.6 (2.3–13.9)],
severe histological activity [OR: 3.1 (1.3–7.3)] and severe fibrosis [OR:
4.7 (1.3–17.3)] in monoinfected patients.
Conclusions
Steatosis is significantly more common and severe in HIV-HCV coinfected
than in HCV monoinfected French patients, even after matching for body
mass index and HCV genotype. Steatosis is associated only with severe
histological activity in coinfected patients and with previously reported
factors in monoinfected patients, thus suggesting different underlying
mechanisms.
Aliment Pharmacol Ther 26, 1489–1498
ª 2007 The Authors 1489
Journal compilation ª 2007 Blackwell Publishing Ltd
doi:10.1111/j.1365-2036.2007.03533.x