| The objective of this study was to determine if angiotensin converting enzyme inhibitors (ACE-Is) attenuate liver fibrosis in HIV and hepatitis C co-infection, a group with accelerated liver disease. Noninvasive indices of liver fibrosis were compared across 156 subjects; one group had taken an ACE-I for up to three years versus controls who had not taken these medications. On analysis, controls were younger and less likely to be black compared to the group on an ACE-I. The use of ACE-Is for three years was independently associated with an elevated fibrosis score adjusted for clinical evidence of advanced fibrosis, age, race, and HIV viral load (p<0.001). There were also significant associations between the indices and significant fibrosis as determined by clinical and radiologic data. Thus, there was not a protective effect of angiotensin inhibition on liver fibrosis in co-infection, but noninvasive indices may be useful for ruling out significant fibrosis. |
