Increased fibrosis progression in menopausal coinfected women

493 HIV/HCV coinfected women were followed longitudinallyfor a median time of 9.1 years for fibrosis progression. Aminotransferaseplatelet ratio index (APRI) and fibrosis 4 (FIB-4)were used to estimate fibrosis progression. 405 women were premenopausalbased on measurement of anti-Müllerian hormone(AMH) with a median age of 37 years. AMH was used to defineperi- and post-menopause. Fibrosis progression during peri- andpost-menopause was significantly faster compared to pre-menopausewith either APRI or FIB-4. The change in FIB-4 was0.12 units faster per year during peri-menopause and 0.14 fasterduring post-menopause.

Sarkar et al. Clin Infect Dis 2017;65:1695-1702

Comment: Men with HCV infection are reported to generallyhave faster fibrosis progression than women with HCV. Thefaster progression during and after menopause in women mayimplicate a protective effect of estrogen which may also to someextent explain why men progress faster than women.