Persistently normal alanine aminotransferase levels in HIV/HCV-coinfected patients: the role of steatosis |
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| Authors: | F Bani-Sadr,K Barange,F Daoud,C Jacomet,A Bicart-See,E Rosenthal,P Cacoub,S Pol,C Perronne,F Carrat, the ANRS HC &ndash Ribavic Study Team |
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| Affiliation: | Groupe Hospitalier Universitaire Est, INSERM U 707, UniversitéPierre et Marie Curie (UPMC-Paris 6), Paris, France,;Hôpital Purpan, Toulouse, France,;Centre Hospitalier Universitaire de la Croix-Rousse, Lyon, France,;Centre Hospitalier Universitaire de Clermont Ferrand, Clermont Ferrand, France,;Hôpital Joseph Ducuing, Toulouse, France,;Hôpital de l'Archet, Nice, France,;Groupe Hospitalier Universitaire Est, UniversitéParis 6, UMR 7087, Paris, France,;Groupe Hospitalier Universitaire Ouest, UniversitéParis 5, INSERM U370, Paris, France and;Centre Hospitalier Universitaire Raymond Poincaré, Universitéde Versailles, Garches, France |
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| Abstract: | Objective The frequency and significance of, and liver biopsy findings associated with, a persistently normal alanine aminotransferase (ALT) level in HIV/hepatitis C virus (HCV)‐coinfected patients are poorly characterized. We analysed factors associated with persistently normal ALT levels, defined as at least three consecutive normal ALT values over a 6‐month period, in a group of 381 HIV/HCV‐coinfected patients. Methods Patients were categorized into two groups according to ALT values: group 1, patients with persistently normal ALT levels; and group 2, patients with elevated ALT values. Possible interactions with host factors, HIV and HCV viral factors, antiretroviral treatment and histological features were examined. Results Thirty‐six patients (9.4%) had persistently normal ALT levels. None of the 36 patients had cirrhosis. Seven patients (19.4%) had a METAVIR fibrosis score of F3. In multivariate analysis, a lower mean METAVIR inflammation score [odds ratio (OR) 0.50, 95% confidence interval (CI) 0.28–0.89; P=0.017], the absence of steatosis (OR 0.43, 95% CI 0.20–0.90; P=0.026) and HCV genotype 4 infection (OR 2.81, 95% CI 1.15–6.68; P=0.023) were associated with persistently normal ALT levels. Conclusion The slower progression of chronic hepatitis in patients with persistently normal ALT levels could be related, in part, to a lower frequency of steatosis |
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| Keywords: | HCV genotype 4 HIV/HCV coinfection liver inflammation score normal alanine aminotransferase steatosis |
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