HIV-HBV coinfection and liver fibrosis in long time monitored patients from the former Romanian pediatric HIV cohort – a small study single center experience

Abstract

The aim of this study was to determine the degree of liver fibrosis with the help of a non-invasive method - transient elastography - in a long term monitored HIV-HBV coinfected group of patients (from the former Romanian pediatric cohort) and to assess the implication of various factors as potential risk factors for the development of liver fibrosis. We have reviewed a total of 636 patients (Px) that were in the evidence of the HIV Department of the “Victor Babes” Hospital of Infectious Diseases of Craiova, from which we randomly selected a group of 37 patients that are monthly attending the HIV department. Mean age of the patients was 34.03±2 years old and they were monitored for a long period of time, mean duration of monitorization was 26.11±4.31 years. Patients have been split into group A (13 Px) with various degrees of liver fibrosis and group B (24 Px) without liver fibrosis; the mean value of liver stiffness was higher in group A vs group B 11.27±5.72 vs.4.93±0.98 kPa, p <0.0001. Mean value of nadir CD4 was lower in group A. No significant differences were found between the 2 groups related to the number of associated risk factors, duration of treatment with Zidovudine, Didanosine, Zalcitabine, Stavudine, non-nucleoside reverse transcriptase inhibitor or Ritonavir. Longer duration with Lamivudine alone was associated with group A, while dual therapy (Tenofovir based) was characteristic with group B. In conclusion in a prolonged monitoring of HIV-HBV coinfected patients (from the former Romanian pediatric HIV cohort) liver fibrosis is associated with longer use of Lamivudine and shorter use or Tenofovir.