The impact of steatosis on the risk of progression of fibrosis is real co-infection, as in the mono-infection. Steatosis appears in multivariate analysis as one of the main elements associated with the progression of fibrosis in patients with serial biopsies approximately 3 years apart (28% of an increase of more than 2 points) 26.Dans APRICOT trial, as well as in the test RIBAVIC ANRS HC02-., steatosis does not seem to influence the response rate virological..

In summary, the steatosis in HIV infection is common and multi-factorial. It is associated with modifiable metabolic (HDL cholesterol lower, lipodystrophy, body mass index) but also in HCV infection to be treated. During co-infection HIV-HCV, steatosis increases fibrosis but does not seem to influence the rate of SVR, which allow a significant reduction in steatosis.

Many studies have reported the deleterious impact of HCV on morbidity and mortality in patients infected with HIV more than the die Development of antiretroviral therapy has reduced the weight of various opportunistic infections 27. It has also been shown that liver biopsy was a brake support of hepatitis C in patients co-infected. Ask an indication of anti-HCV implies knowledge of the extent of liver damage. In recent years, the role of liver biopsy (biopsy) for evaluation of liver lesions is discussed: its risks are not zero (morbidity 0.3% – 0.5% and 0.03% -0.1% mortality) and its findings are subject to a share of inter-subject variability and intra-observer and secondly to the varying quality levy. Several non-invasive alternatives have been proposed and applied to patients co-infected HIV-HCV to assess the stage of fibrosis, inflammatory activity or steatosis.