HIV infection does not increase the risk of liver complications in hepatitis C virus-infected patient with advanced fibrosis, after sustained virological response with direct-acting antivirals
OBJECTIVE: To assess the impact of HIV coinfection on the risk of developing liver-related complications in HCV-infected patients with advanced fibrosis treated with direct-acting antivirals (DAA) after sustained virological response (SVR).
DESIGN: Prospective cohort study.
SETTING: Multicenter.
SUBJECTS: Patients from the GEHEP and HEPAVIR cohorts were selected if they fulfilled the following criteria: treatment against HCV with all oral DAA combination; SVR achievement, defined as undetectable plasma HCV RNA 12 weeks after the end of therapy; pretreatment liver stiffness equal to or higher than 9.5 kPa; liver stiffness measurement at the time of SVR.
MAIN OUTCOME MEASURE(S): The primary variable was the time until the development of a liver complication or requiring liver transplant.
RESULTS: Seven hundred and seventeen patients were included and 507 (71%) were coinfected with HIV. After a median follow-up time of 21 (14-25) months, 15 (2.1%) patients developed a liver complication and/or underwent a liver transplant and 15 (2.0%) died. The probability of remaining free of hepatic complications or transplant at 1 and 2 was, respectively, 99 and 96% in HCV-monoinfected patients and 99 and 98% in coinfected patients (P = 0.648). In a multivariate analysis, in which nonliver-related death was considered as a competing event, HIV coinfection was not associated with the appearance of hepatic complications or requiring liver transplant [hazard ratio = 0.24; 95% CI (0.03-1.93), P = 0.181]. Having presented hepatic decompensation prior to SVR [hazard ratio = 29.06; 95% CI (3.91-216.16), P < 0.001] and the value of liver stiffness at the SVR time-point (hazard ratio = 1.12; 95% CI (1.07-1.18), P < 0.001] were associated with a higher probability of development of liver events.
CONCLUSION: HIV coinfection is not associated with a higher probability of developing liver complications in HCV-infected patients with advanced fibrosis, who achieved SVR with interferon-free regimens.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:33 |
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| Enthalten in: |
AIDS (London, England) - 33(2019), 7 vom: 01. Juni, Seite 1167-1174 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Corma-Gómez, Anaïs [VerfasserIn] |
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| Links: |
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| Themen: |
Antiviral Agents |
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| Anmerkungen: |
Date Completed 21.07.2020 Date Revised 21.07.2020 published: Print Citation Status MEDLINE |
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| doi: |
10.1097/QAD.0000000000002186 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM294689222 |
|---|
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| 100 | 1 | |a Corma-Gómez, Anaïs |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a HIV infection does not increase the risk of liver complications in hepatitis C virus-infected patient with advanced fibrosis, after sustained virological response with direct-acting antivirals |
| 264 | 1 | |c 2019 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
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| 500 | |a Date Completed 21.07.2020 | ||
| 500 | |a Date Revised 21.07.2020 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE: To assess the impact of HIV coinfection on the risk of developing liver-related complications in HCV-infected patients with advanced fibrosis treated with direct-acting antivirals (DAA) after sustained virological response (SVR) | ||
| 520 | |a DESIGN: Prospective cohort study | ||
| 520 | |a SETTING: Multicenter | ||
| 520 | |a SUBJECTS: Patients from the GEHEP and HEPAVIR cohorts were selected if they fulfilled the following criteria: treatment against HCV with all oral DAA combination; SVR achievement, defined as undetectable plasma HCV RNA 12 weeks after the end of therapy; pretreatment liver stiffness equal to or higher than 9.5 kPa; liver stiffness measurement at the time of SVR | ||
| 520 | |a MAIN OUTCOME MEASURE(S): The primary variable was the time until the development of a liver complication or requiring liver transplant | ||
| 520 | |a RESULTS: Seven hundred and seventeen patients were included and 507 (71%) were coinfected with HIV. After a median follow-up time of 21 (14-25) months, 15 (2.1%) patients developed a liver complication and/or underwent a liver transplant and 15 (2.0%) died. The probability of remaining free of hepatic complications or transplant at 1 and 2 was, respectively, 99 and 96% in HCV-monoinfected patients and 99 and 98% in coinfected patients (P = 0.648). In a multivariate analysis, in which nonliver-related death was considered as a competing event, HIV coinfection was not associated with the appearance of hepatic complications or requiring liver transplant [hazard ratio = 0.24; 95% CI (0.03-1.93), P = 0.181]. Having presented hepatic decompensation prior to SVR [hazard ratio = 29.06; 95% CI (3.91-216.16), P < 0.001] and the value of liver stiffness at the SVR time-point (hazard ratio = 1.12; 95% CI (1.07-1.18), P < 0.001] were associated with a higher probability of development of liver events | ||
| 520 | |a CONCLUSION: HIV coinfection is not associated with a higher probability of developing liver complications in HCV-infected patients with advanced fibrosis, who achieved SVR with interferon-free regimens | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
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| 700 | 1 | |a Morano, Luis |e verfasserin |4 aut | |
| 700 | 1 | |a Téllez, Francisco |e verfasserin |4 aut | |
| 700 | 1 | |a Rivero-Juárez, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Real, Luis M |e verfasserin |4 aut | |
| 700 | 1 | |a Alados, Juan Carlos |e verfasserin |4 aut | |
| 700 | 1 | |a Ríos-Villegas, María José |e verfasserin |4 aut | |
| 700 | 1 | |a Vera-Méndez, Francisco Jesús |e verfasserin |4 aut | |
| 700 | 1 | |a Muñoz, Rosario Palacios |e verfasserin |4 aut | |
| 700 | 1 | |a Geijo, Paloma |e verfasserin |4 aut | |
| 700 | 1 | |a Macías, Juan |e verfasserin |4 aut | |
| 700 | 1 | |a Pineda, Juan A |e verfasserin |4 aut | |
| 700 | 0 | |a RIS-HEP13 and GEHEP 011 study groups |e verfasserin |4 aut | |
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