Aging Accelerates Liver Fibrosis Progression Among Women with HIV/HCV

Hepatic fibrosis accelerates with reproductive aging among women with HIV and hepatitis C (HCV) coinfections, according to a recent study.

In their longitudinal study, the researchers assessed fibrosis progression among 405 women with HIV and HCV for a median 9.1 years. Serum fibrosis markers, aminotransferase platelet ratio index (APRI) and fibrosis 4 (FIB-4) were used to measure fibrosis progression. In addition, the rate of fibrosis was evaluated as each woman transitioned from pre- to post-menopause, which was defined by ovarian function biomarkers.
HIV Raises CVD Risk in Pre-Menopausal Women
HIV Viral Rebound Can Occur in Pregnant Women on Combination ART
How Does Statin Use Affect the Liver in Patients with HIV/HCV?

After controlling for chronologic aging, FIB-4 and APRI measurements demonstrated that the fibrosis progression rate was accelerated during perimenopause. Additionally, fibrosis acceleration was observed more during post-menopause compared with pre-menopause.

Furthermore, the acceleration of fibrosis during perimenopause persisted after researchers adjusted for Hispanic ethnicity, antiretroviral use, and alcohol consumption.

“Accelerated fibrosis begins in perimenopause, highlighting a previously unrecognized group of women at increased risk for advanced fibrosis and associated complications,” the researchers concluded. “Longitudinal analyses of fibrosis rates across reproductive age should be conducted in non–HCV-related liver diseases, given potential implications in a broader spectrum of women.”

—Melissa Weiss


Sarkar M, Dodge JL, Greenblatt RM, et al. Reproductive aging and hepatic fibrosis progression in human immunodeficiency virus/hepatitis C virus–coinfected women. Clin Infect Dis. 2017; 65;10 (30): 1695–1702.