Published online Jun 27, 2022. doi: 10.4254/wjh.v14.i6.1173
Peer-review started: December 12, 2021
First decision: March 24, 2022
Revised: April 16, 2022
Accepted: May 28, 2022
Article in press: May 28, 2022
Published online: June 27, 2022
Human immunodeficiency virus/hepatitis C virus (HIV/HCV)-coinfected patients may have a poor prognosis, as evidence suggests that HIV infection negatively impacts the progression of liver disease, particularly increasing the risks of developing fibrosis and hepatocellular carcinoma, although this can be controversial. Both HIV and HCV negatively affect the nutritional status of patients, regardless of the stage of the disease. In addition, nutritional assessment in patients with chronic liver disease has limitations due to the body asymmetry (e.g., ascites and edema) that these patients may experience as a result of complications from liver cirrhosis, in addition to the lack of a standard method.
There is a strong association between muscle mass loss and liver diseases, regardless of obesity or metabolic syndrome, and identifying a method that indicates these physiological impairments is of paramount importance.
To the best of our knowledge, no studies have assessed the role of phase angle (PA) and its body composition associated with hepatic steatosis and fibrosis in HIV/HCV-coinfected patients.
A retrospective observational study by convenience sampling with coinfected HIV/HCV patients, where all patients underwent transient elastography (Fibroscan) and bioelectrical impedance analysis evaluation. Student’s t-test was used for group comparisons and Spearman’s or Pearson’s correlation tests were used when appropriate. The significance level adopted was 5% and the analyses were performed using the SPSS version 21.0.
Of 43 patients who were analyzed, male sex was more frequent (22; 51.2%), mean age was 46.2 ± 8.5 years, HCV genotype 1 was the most frequent (n = 30; 69.7%), and 27 (62.8%) presented with advanced fibrosis (F3/F4). There was no correlation between the fibrosis grade and the PA (P = 0.355). Also, there was no correlation between the fibrosis grade and the lean mass (P = 0.378). The mean controlled attenuation parameter (CAP) was 241.1 ± 55.7, and there was a significant inverse correlation between CAP and percentual of lean mass (P = 0.01). Although no significant correlations between CAP and PA were found, there was a positive correlation between PA and lean mass (P = 0.014), and a negative correlation between PA and fatty mass (P = 0.014). Additionally, when evaluated by sex, there were no significant correlations.
The PA determines the muscle function of the HIV/HCV-coinfected patients, and the CAP values reinforce the association with lean mass (both show a relationship with muscle mass, the PA and the CAP), suggesting patients who need early nutritional intervention.
Identifying clinical factors that potentiate a poor prognosis of patients coinfected with HIV/HCV, such as malnutrition, is of relevance. With this information, it is possible to act early in the management of these patients and increase the effectiveness of the therapeutic response, with a consequent improvement in the prognosis and quality of life of this population.