CHARACTERISTICS OF CHRONIC HEPATITIS-C IN HIV-INFECTED PATIENTS

Objectives. To know the characteristics of chronic hepatitis C in HIV- infected patients and whether there are differences compared with HIV- negative patients, in order to obtain orientative helpful data for the diagnostic-therapeutic decision making, a usually difficult issue in these patients. Patients and methods. Sixty patients with criteria of chronic hepatitis C virus (HCV) criteria were studied. Thirty-three of these patients were coinfected with HIV. The possible associations be tween the degree of histologic damage and several variables wee studie d: age, estimated time of evolution of HCV infection, transaminases, g ammaglobulins, GGT, and alcohol consumption. On the other hand, the po ssible differences regarding the histologic hepatic aggression were as sessed. An attempt was made to know whether HIV could negatively influ ence the evolution of chronic hepatitis C. Results. A direct relations hip was obseved between hepatic damage, HAI and levels of GOT, GPT, GG T (p < 0.005), and gammaglobulins (p < 0.01). The degree of hepatic fi brosis was directly correlated with the GGT level (mild fibrosis: 47 /- 34 U/l; severe fibrosis: 86 +/- 60 U/l) (p < 0.05) and the estimate d evolution time of infection (p < 0.05). Alcohol consumption was asso ciated with the fibrosis degree (p < 0.01). The degree of histologic d amage was similar in the HIV-positive group (HAI: 8.3 +/- 3.6) and HIV -negative patients (HAI: 7.2 +/- 2.8), although the degree of lobulill ar involvement was higher in HIV-positive patients (p < 0.05). Conclus ions. Patients with chronic hepatitis C and infected with HIV did not have a higher degree of hepatic damage than HIV-negative patients. GOT , GPT, and gamma globulin levels, as well as a longer evolution time o f HCV infection were associated with a higher degree of hepatic histol ogic activity. Alcohol consumption seemed to be associated with a poor er course of the liver disease in these patients.