HEPATIC HISTOLOGY OF PATIENTS WITH HIV-INFECTION AND CHRONIC HEPATITIS-C TREATED WITH INTERFERON

Aims-To evaluate the histological changes seen in liver biopsies after interferon (IFN) treatment in patients with chronic hepatitis C and h uman immunodeficiency virus (HIV) infection. Methods-Twenty four intra venous drug users with chronic hepatitis C were investigated histologi cally before beginning a 12 month course of IFN treatment and 18 month s later. Twelve were HIV positive, without opportunistic or other vira l infections (group A), and 12 were HIV negative (group B). Results-Ac cording to alanine aminotransferase concentrations, four sustained res ponders and eight non-responders were found in group A; six sustained responders, five relapsers, and one non-responder were found in group B. HCV RNA became negative in one sustained responder of group A and i n the six sustained responders of group B. When histological findings of biopsies performed before therapy and 18 months later were compared , no significant changes in the mean value of Knodell's index and subi ndices were found in group A, whereas in group B Knodell's index, piec emeal necrosis, and focal hepatocellular necrosis decreased significan tly. Conclusions-In chronic hepatitis C, co-infection with HIV showed a tendency towards a lower response to IFN, although this did not reac h statistical significance; however, none of the HIV positive patients developed cirrhosis during the follow up and this should be considere d in clinical management of such patients.