Lower CD4 cell count and higher HIV viral load are associated with progression to advanced hepatic fibrosis, according to research published in the Journal of Acquired Immune Deficiency Syndromes.

H. Nina Kim, MD, MSc, Associate Professor, Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, and colleagues conducted a study of the presence of liver disease among patients with HIV-infection. Using the Fibrosis-4 index, the researchers determined the incidence and predictors of advance hepatic fibrosis in a large population of patients with HIV-infection without significant liver disease at baseline.

Among the 14,198 patients with HIV-infection studied, hepatitis C virus coinfection, hepatitis B virus coinfection, alcohol-use disorder, and diabetes were most largely associated with progression to advanced fibrosis. Patients who had lower levels of time-varying CD4 cell counts had a significantly greater risk of undergoing this progression.

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“Lower CD4 cell count and higher HIV viral load were significantly associated with progression to advanced hepatic fibrosis in a dose-dependent manner, independent of the risk associated with traditional factors: hepatitis C virus or hepatitis B virus coinfection, alcohol, and diabetes,” concluded Dr Kim. “Our findings suggest that early treatment of HIV infection could mitigate liver disease.”


  1. Kim HN, Nance R, Van Romapey S, et al. Poorly controlled HIV infection: An independent risk factor for liver fibrosis. J Acquir Immune Defic Syndr. 2016;72(4):437-443; doi: 10.1097/QAI00000000000000992