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Fw: NATAP: Steatosis in HIV/HCV Coinfected

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  • alleypat
    NATAP http://natap.org/ ... Prevalence of and Factors Associated With Hepatic Steatosis in Patients Coinfected With Hepatitis C Virus and HIV: Agence Nationale
    Message 1 of 1 , May 26, 2007
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      Prevalence of and Factors Associated With Hepatic Steatosis in Patients Coinfected With Hepatitis C Virus and HIV: Agence Nationale pour la Recherche contre le SIDA et les hepatites virales CO3 Aquitaine Cohort.

      Note from Jules; should steatosis by treated in coinfected patients, in patients with diabetes, others?? It is a question worth considering as well as studying this question.

      Clinical Science JAIDS Journal of Acquired Immune Deficiency Syndromes. 45(2):168-173, June 1, 2007.

      Neau, Didier MD, PhD *; Winnock, Maria PhD +; Castera, Laurent MD ++; Bail, Brigitte Le MD, PhD [S]; Loko, Marc-Arthur MD +; Geraut, Laurent MD *; Dupon, Michel MD *; Ragnaud, Jean-Marie MD *; Lacoste, Denis MD [//][P]; Lafon, Marie-Edith MD, PhD #; Bioulac-Sage, Paulette MD, PhD [S]; Dabis, Francois MD, PhD +[P]; the Groupe d'Epidemiologie Clinique du SIDA en Aquitaine +[P]

      Abstract:
      Background: Hepatic steatosis is a common feature in liver biopsies from patients with chronic hepatitis C and is associated with fibrosis progression. Patients with HIV infection and hepatitis C virus (HCV) coinfection have more rapid progression of liver fibrosis than patients with HCV infection alone. The prevalence and factors associated with hepatic steatosis are not well defined in HCV-HIV-coinfected patients.

      Methods: Steatosis was assessed among 148 HCV-HIV-coinfected patients of the Aquitaine Cohort. Steatosis was graded as follows: none, mild (1%-10% of hepatocytes), moderate (11%-30%), severe (31%-60%), and massive (more than 60%). Epidemiologic, clinical, biologic, and therapeutic data were retrieved from the cohort database to investigate the risk factors.

      Results: Steatosis was present in 67% of patients (95% confidence interval [CI]: 59% to 74%) and was at least moderate in 30% (95% CI: 23% to 38%). Steatosis was macrovesicular or mixed (macro- and microvesicular) in 40.5% and 52.8% of patients, respectively. Necroinflammatory activity was the only factor independent of steatosis (adjusted odds ratio = 5.3, 95% CI: 1.6 to 17.9). When necroinflammatory activity was removed from the model, HCV genotype 3 and body mass index (BMI) were significantly associated with steatosis.

      Conclusions: Liver inflammation, HCV genotype 3, and BMI are associated with steatosis, a common finding in HCV-HIV-coinfected patients.


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