Skip to main content

Advertisement

SpringerLink
Log in

Absence of liver steatosis in HIV–HCV co-infected patients receiving regimens containing tenofovir or abacavir

  • Clinical and Epidemiological Study
  • Published:
Infection Aims and scope Submit manuscript

Abstract

Background

In human immunodeficiency virus–hepatitis C virus (HIV–HCV) co-infected patients, steatosis has been independently associated with a number of antiretroviral drugs, including stavudine, especially in patients with non-3 HCV genotypes. We retrospectively investigated the presence of steatosis among HIV–HCV co-infected and HCV mono-infected patients, and the role of tenofovir disoproxil fumarate (TDF) or abacavir (ABC) in determining hepatic steatosis.

Methods

Liver steatosis was retrospectively evaluated in all consecutive biopsies performed in the period 2000–2008 in HCV mono-infected and HIV–HCV co-infected patients. A steatosis rate of >5 % was considered to be significant, and a multivariate logistic analysis was performed to evaluate factors associated with steatosis.

Results

In total, 393 HCV-infected patients underwent liver biopsy during the study period, of whom 205 (52.2 %) were co-infected with HIV. A steatosis rate of >5 % was diagnosed in 33.0 % of HCV mono-infected and in 47.8 % of HIV–HCV co-infected patients (P = 0.003). The rate of steatosis was higher in patients resuming antiretroviral therapy (54.7 %) than in naïve patients (33.3 %; P = 0.006). When the overall population was considered, steatosis was associated to HCV genotype 3 [odds ratio (OR) 4.53, 95 % confidence interval (CI) 2.71–7.58; P < 0.001]. In terms of the use of nucleos(t)ide drugs in HIV co-infected patients, multivariate analysis showed that only in patients with HCV genotypes other than genotype 3 was steatosis related to the use of stavudine (OR 5.38, 95 % CI 1.18-24.53; P = 0.03). The use of TDF (OR 1.07, 95 % CI 0.39–2.88; P = 0.898) or ABC (OR 0.592, 95 % CI 0.09–4.07; P = 0.594) was not associated with steatosis.

Conclusion

In HCV mono-infected and HIV–HCV co-infected patients, steatosis appears to be a virus-mediated effect of HCV genotype 3. In HIV patients infected with HCV genotypes other than genotype 3, the risk of developing steatosis was higher in those patients resuming antiretroviral regimens containing old drugs rather than the new antiretrovirals.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Crum-Cianflone N, Dilay A, Collins G, Asher D, Campin R, Medina S, Goodman Z, Parker R, Lifson A, Capozza T, Bavaro M, Hale B, Hames C. Non-alcoholic fatty liver disease among HIV-infected persons. J Acquir Immune Defic Syndr. 2009;50(5):464–73.

    Article  PubMed  Google Scholar 

  2. Guaraldi G, Squillace N, Stentarelli C, Orlando G, D’Amico R, Ligabue G, Fiocchi F, Zona S, Loria P, Esposito R, Palella F. Non-alcoholic fatty liver disease in HIV-infected patients referred to a metabolic clinic: prevalence, characteristics, and predictors. Clin Infect Dis. 2008;47(2):250–7.

    Article  PubMed  Google Scholar 

  3. Ryan P, Blanco F, García-Gascó P, García-Merchán J, Vispo E, Barreiro P, Labarga P, González-Lahoz J, Soriano V. Predictors of severe hepatic steatosis using abdominal ultrasound in HIV-infected patients. HIV Med. 2009;10(1):53–9.

    Article  PubMed  CAS  Google Scholar 

  4. Negro F. Insulin resistance and HCV: will new knowledge modify clinical management? J Hepatol. 2005;45:514–9.

    Article  Google Scholar 

  5. Cicconi P, Cozzi-Lepri A, Phillips A, Puoti M, Antonucci G, Manconi PE, Tositti G, Colangeli V, Lichtner M, Monforte A. ICoNA Study Group. Is the increased risk of liver enzyme elevation in patients co-infected with HIV and hepatitis virus greater in those taking antiretroviral therapy? AIDS. 2007;21(5):599–606.

    Article  PubMed  CAS  Google Scholar 

  6. Borghi V, Puoti M, Mussini C, Bellelli S, Angeletti C, Sabbatini F, Prati F, Cossarizza A, Esposito R. HIV coinfection and antiretroviral therapy enhances liver steatosis in patients with hepatitis C, but only in those infected by HCV genotype other than 3. Antivir Ther. 2008;13(8):1057–65.

    PubMed  Google Scholar 

  7. Leone S, Gregis G, Quinzan G, Velenti D, Cologni G, Soavi L, Ravasio V, Ripamonti D, Suter F, Maggiolo F. Causes of death and risk factors among HIV-infected persons in the HAART era: analysis of a large urban cohort. Infection. 2011;39(1):13–20.

    Article  PubMed  CAS  Google Scholar 

  8. Zeremski M, Talal AH. Dideoxynucleoside analogues should be used cautiously in patients with hepatic steatosis. Clin Inf Dis. 2006;43:373–6.

    Article  CAS  Google Scholar 

  9. McGovern BH, Ditelberg JS, Taylor LE, Gandhi RT, Christopoulos KA, Chapman S, Schwartzapfel B, Rindler E, Fiorino AM, Zaman MT, Sax PE, Graeme-Cook F, Hibberd PL. Hepatic steatosis is associated with fibrosis, nucleoside analogue use, and hepatitis C virus genotype 3 infection in HIV-seropositive patients. Clin Infect Dis. 2006;43:365–72.

    Article  PubMed  CAS  Google Scholar 

  10. Sulkowski MS, Mehta SH, Torbenson M, Afdhal NH, Mirel L, Moore RD, Thomas DL. Hepatic steatosis and antiretroviral drug use among adults coinfected with HIV and hepatitis C virus. AIDS. 2005;19:585–92.

    Article  PubMed  Google Scholar 

  11. Monto A, Dove LM, Bostrom A, Kakar S, Tien PC, Wright TL. Hepatic steatosis in HIV/hepatitis C coinfection: prevalence and significance compared with hepatitis C monoinfection. Hepatology. 2005;42:310–6.

    Article  PubMed  Google Scholar 

  12. Marks KM, Petrovic LM, Talal AH, Murray MP, Gulick RM, Glesby MJ. Histological findings and clinical characteristics associated with hepatic steatosis in patients coinfected with HIV and hepatitis C virus. J Infect Dis. 2005;192:1943–9.

    Article  PubMed  Google Scholar 

  13. Bani-Sadr F, Carrat F, Bedossa P, Piroth L, Cacoub P, Perronne C, Degott C. ANRS HC02-Ribavic Study team. Hepatic steatosis in HIV–HCV coinfected patients: analysis of risk factors. AIDS. 2006;20:525–31.

    Article  PubMed  Google Scholar 

  14. Gaslightwala I, Bini EJ. Impact of human immunodeficiency virus infection on the prevalence and severity of steatosis in patients with chronic hepatitis C virus infection. J Hepatol. 2006;44:1026–32.

    Article  PubMed  CAS  Google Scholar 

  15. Cossarizza A, Moyle G. Antiretroviral nucleoside and nucleotide analogues and mitochondria. AIDS. 2004;18:137–51.

    Article  PubMed  CAS  Google Scholar 

  16. Fleischman A, Johnsen S, Systrom DM, Hrovat M, Farrar CT, Frontera W, Fitch K, Thomas BJ, Torriani M, Côté HC, Grinspoon SK. Effects of a nucleoside reverse transcriptase inhibitor, stavudine, on glucose disposal and mitochondrial function in muscle of healthy adults. Am J Physiol Endocrinol Metab. 2007;292:1666–73.

    Article  Google Scholar 

  17. Venhoff N, Setzer B, Melkaoui K, Walker UA. Mitochondrial toxicity of tenofovir, emtricitabine and abacavir alone and in combination with additional nucleoside reverse transcriptase inhibitors. Antivir Ther. 2007;12:1075–85.

    PubMed  CAS  Google Scholar 

  18. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services, National Institutes of Health, Bethesda. Available at: http://www.aidsinfo.nih.gov/contentfiles/lvguidelines/adultandadolescentgl.pdf Accessed 20 Nov 2012.

  19. Linee Guida Italiane sull’utilizzo dei farmaci antiretrovirali e sulla gestione diagnostico-clinica delle persone con infezione da HIV-1. Available at: http://www.salute.gov.it/imgs/C_17_pubblicazioni_1793_allegato.pdf Accessed 20 Nov 2012.

  20. Ishak K, Baptista A, Bianchi L, Callea F, De Groote J, Gudat F, Denk H, Desmet V, Korb G, MacSween RN. Histological grading and staging of chronic hepatitis. J Hepatol. 1995;22:696–9.

    Article  PubMed  CAS  Google Scholar 

  21. Negro F. Insulin resistance and HCV: will new knowledge modify clinical management? J Hepatol. 2005;45:514–9.

    Article  Google Scholar 

  22. Halfon P, Pénaranda G, Carrat F, Bedossa P, Bourlière M, Ouzan D, Renou C, Tran A, Rosenthal E, Wartelle C, Delasalle P, Cacoub P. Influence of insulin resistance on hepatic fibrosis and steatosis in hepatitis C virus (HCV) mono-infected compared with HIV–HCV co-infected patients. Aliment Pharmacol Ther. 2009;30:61–70.

    Article  PubMed  CAS  Google Scholar 

  23. Maggiolo F, Roat E, Pinti M, Nasi M, Gibellini L, De Biasi S, Airoldi M, Ravasio V, Mussini C, Suter F, Cossarizza A. Mitochondrial changes during D-drug-containing once-daily therapy in HIV-positive treatment-naive patients. Antivir Ther. 2010;15:51–9.

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Clinic of Infectious and Tropical Diseases, Azienda Ospedaliero–Universitaria Policlinico di Modena, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41100, Modena, Italy

    V. Borghi, L. Bisi, L. Manzini & C. Mussini

  2. Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy

    A. Cossarizza & C. Mussini

Authors
  1. V. Borghi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L. Bisi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L. Manzini
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Cossarizza
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. C. Mussini
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to V. Borghi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Borghi, V., Bisi, L., Manzini, L. et al. Absence of liver steatosis in HIV–HCV co-infected patients receiving regimens containing tenofovir or abacavir. Infection 41, 425–429 (2013). https://doi.org/10.1007/s15010-012-0378-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s15010-012-0378-7

Keywords

Search

Navigation