Hepatitis News

Faster hep C damage in people who already have HIV

Hepatitis C infection causes liver damage five times faster if people catching it already have HIV, an American study suggests.

The study by Daniel Fierer of Mount Sinai hospital in New York found that his HIV-positive gay male patients developed liver damage five times faster if they also caught hepatitis C than did comparable HIV-negative patients in the early stages of hepatitis C infection.

Furthermore, the liver damage in such acute infections progressed twenty times faster than it did in patients with long-term hepatitis C infection who then caught HIV.

It appears that new hep C infections are particularly dangerous for this group.

Fierer had already reported to the 2007 Retrovirus Conference that out of five HIV-positive patients he’d seen who’d been infected with HIV less than six months previously, four had already moderate scarring in their livers. This scarring, caused by the hep C virus, damages the liver and can eventually lead to cirrhosis and liver failure.

In an update to the 2008 Conference, Fierer said he now had eleven gay male patients with recently-acquired hepatitis C who’d undergone liver biopsies to gauge the extent of damage. Nine of those had biopsies were done within 20 weeks of infection.

He found that nine of the eleven had stage two (moderate) fibrosis and one had stage one (slight).

Fibrosis is measured on a scale from one to four, with four indicating cirrhosis. At this rate, these patients could in theory develop cirrhosis within a year. This compares with an average time to cirrhosis of 10-20 years for patients with hep C who then get HIV, and 30-40 years for patients with hep C alone. However, at the moment Fierer does not yet have enough data to know if the rapid liver damage will continue beyond the stage of initial infection or whether his patients will develop more tolerance of the hep C virus.

“Further research is needed to identify the disease processes leading to this highly accelerated liver injury,” concluded Fierer.

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