Gaslightwala Irphan, Bini Edmund J
Division of Gastroenterology, VA New York Harbor Healthcare System, 423 East 23rd Street, New York, NY 10010, USA.
J Hepatol. 2006 Jun;44(6):1026-32. doi: 10.1016/j.jhep.2006.02.009. Epub 2006 Mar 13.
BACKGROUND/AIMS: Although steatosis is strongly associated with hepatitis C virus (HCV) infection, little is known about this finding in patients coinfected with human immunodeficiency virus (HIV) and HCV. The aims of the present study were to determine the prevalence and severity of steatosis in HIV/HCV coinfected patients.
Consecutive patients undergoing liver biopsy were prospectively identified and were interviewed to obtain detailed demographic and clinical data. Steatosis was scored according to the percentage of hepatocytes involved: 0 (none), 1 (<33%), 2 (33-66%), or 3 (>66%); fibrosis was scored on a scale from 0 to 4.
A total of 708 patients were enrolled, including 154 with HIV/HCV coinfection and 554 with HCV monoinfection. Steatosis of any grade (72.1 vs. 52.0%, P<0.001), grade 2/3 steatosis (48.1 vs. 20.2%, P<0.001), and stage 3/4 fibrosis (43.5 vs. 30.0%, P=0.002) were significantly more common in coinfected patients. Compared to HCV monoinfected subjects, HIV/HCV coinfection was associated with a significantly increased odds of steatosis of any grade (OR=3.21; 95% CI, 1.84-5.60) and grade 2/3 steatosis (OR=5.63; 95% CI, 3.05-10.36) after adjusting for potential confounding variables. Among coinfected patients, the fibrosis progression rate increased in a linear fashion with the grade of steatosis.
Steatosis is more common and more severe in HIV/HCV coinfected patients than in those with HCV monoinfection.
背景/目的：尽管脂肪变性与丙型肝炎病毒（HCV）感染密切相关，但对于人类免疫缺陷病毒（HIV）和HCV合并感染患者的这一发现却知之甚少。本研究的目的是确定HIV/HCV合并感染患者中脂肪变性的患病率和严重程度。
前瞻性地确定接受肝活检的连续患者，并对其进行访谈以获取详细的人口统计学和临床数据。根据受累肝细胞的百分比对脂肪变性进行评分：0（无）、1（<33%）、2（33 - 66%）或3（>66%）；纤维化按0至4级评分。
共纳入708例患者，其中154例为HIV/HCV合并感染，554例为HCV单一感染。任何级别的脂肪变性（72.1%对52.0%，P<0.001）、2/3级脂肪变性（48.1%对20.2%，P<0.001）和3/4期纤维化（43.5%对30.0%，P = 0.002）在合并感染患者中明显更为常见。与HCV单一感染受试者相比，在调整潜在混杂变量后，HIV/HCV合并感染与任何级别的脂肪变性（OR = 3.21；95%CI，1.84 - 5.60）和2/3级脂肪变性（OR = 5.63；95%CI，3.05 - 10.36）的几率显著增加相关。在合并感染患者中，纤维化进展率随脂肪变性级别呈线性增加。
HIV/HCV合并感染患者的脂肪变性比HCV单一感染患者更常见且更严重。
