HCV, waist circumference linked to greater liver stiffness

Bailony MR. J Infect Dis. 2013;doi:10.1093/infdis/jit357.

  • September 12, 2013

Patients with hepatitis C or HCV/HIV coinfection had significantly more liver stiffness than noninfected patients or those with HIV alone in a recent study.

Researchers evaluated liver stiffness as measured via transient elastography (TE) in 165 women with HIV, 14 with HCV, 78 coinfected with HIV and HCV and 57 with neither infection from November 2010 through April 2012. All patients, aged 25 to 65 years, had been enrolled in the multicenter, prospective Women’s Interagency HIV Study.

Median liver stiffness was significantly greater in coinfected patients compared with those without HCV or HIV (7.1 kPa vs. 4.4 kPa; P<.001). Patients with HIV alone had similar values to noninfected patients (4.4 kPa; P=.94).

The association between HIV/HCV coinfection and higher liver stiffness was upheld after multivariate adjustment, with a 74.2% increase relative to noninfected patients (P<.001). Among patients with HCV alone or HIV/HCV coinfection, investigators noted an association between waist circumference and liver stiffness, with 18.7% increased stiffness for every 10 cm increase in circumference (P=.001). History of AIDS also was associated with an estimated 35.5% increase in liver stiffness (P=.03) among HCV patients.

Among HIV monoinfected patients, a history of AIDS was associated with a 12.9% liver stiffness increase (P=.04) after adjustment for confounders, and HIV RNA levels were linked to a 7.3% stiffness increase for every 10-fold RNA increase (P=.01). Hispanic patients with HIV had an estimated 31.4% increase in liver stiffness relative to white patients (P=.01).

Significant fibrosis (liver stiffness >7.1 kPa) was significantly more common among patients with HCV (47% of coinfected and 36% of HCV monoinfected patients vs. 8.8% among noninfected patients; P<.001 for both comparisons).

“Central obesity further worsens liver fibrosis in HCV-infected women, but its effect in the absence of HCV-associated liver injury seems to be lessened,” the researchers concluded. “The mechanisms by which central obesity may worsen liver fibrosis in the setting of underlying HCV-associated liver injury need further investigation, including study of the contribution of hepatic steatosis and inflammation … to liver fibrosis.”

Disclosure: The researchers report no relevant financial disclosures.