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

Corma-Gómez, Anaïs; Morano, Luís; Téllez, Francisco; Rivero‐Juárez, Antonio; Real, Luis Miguel; Alados, Juan Carlos; Ríos‐Villegas, Maria José; Vera-Méndez, Francisco Jesús; Muñoz, Rosario Palacios; Geijo, Paloma; Macı́as, Juan; Pineda, Juan A.; Ris-Hep,; groups, Gehep study

doi:10.1097/qad.0000000000002186

Cited by 19 publications

(22 citation statements)

References 31 publications

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“…Different countries have built specific registries regarding HCV and HIV infections. Most of collected data aims to evaluate the dimension of HCV chronic infection among HIV-infected patients and are mainly focused on the optimization of cART [14][15][16][17][18][19]. The consecutive nature of the enrolled patients and the involvement of clinical centers of different specialties that deal with monoinfected and coinfected patients (i.e., gastroenterology/hepatology, internal medicine and infectious diseases) all over Italy, independently by the access to the therapy, are important peculiarities of PITER cohort.…”

Section: Discussionmentioning

confidence: 99%

Advanced liver disease outcomes after hepatitis C eradication by human immunodeficiency virus infection in PITER cohort

et al. 2020

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Background Liver disease progression after Hepatitis C Virus (HCV) eradication following direct-acting antiviral (DAA) treatment in the real-life setting according to Human Immunodeficiency Virus (HIV) coinfection was evaluated. Methods Patients consecutively enrolled in PITER between April 2014 and June 2019 and with at least 12-weeks follow-up following treatment were analysed. Cox regression analysis were used to evaluate HIV coinfection and factors independently associated with liver disease outcomes following viral eradication in DAA treated patients with pre-treatment liver cirrhosis. Results 93 HIV/HCV coinfected and 1109 HCV monoinfected patients were evaluated during a median follow-up of 26.7 (range 6-44.6) and 24.6 (range 6.8-47.3) months, respectively. No difference in the cumulative HCC incidence and hepatic decompensation was observed between coinfected and monoinfected patients. Age (Hazard Ratio [HR] = 1.08; 95% CI 1.04-1.13), male sex (HR = 2.76; 95% CI 1.28-5.96), lower albumin levels (HR = 3.94; 95% CI 1.81-8.58), genotype 3 (HR = 5.05; 95% CI 1.75-14.57) and serum anti-HBc positivity (HR = 1.99, 95% CI 1.01-3.95) were independently associated with HCC incidence. Older age (HR = 1.03; 95% CI 1.00-1.07), male sex (HR = 2.13; 95% CI 1.06-4.26) and lower albumin levels (HR = 3.75; 95% CI 1.89-7.46) were independently associated with the appearance of a decompensating event after viral eradication. Conclusion Different demographic, clinical and genotype distribution between HIV coinfected vs those monoinfected, was observed in a representative cohort of HCV infected patients in Italy. Once liver cirrhosis is established the disease progression is decreased, but still persists regardless of viral eradication in both coinfected and monoinfected patients. In patients with cirrhosis, HIV coinfection was not associated with a higher probability of liver complications, after viral eradication.

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Section: Discussionmentioning

confidence: 99%

Advanced liver disease outcomes after hepatitis C eradication by human immunodeficiency virus infection in PITER cohort

et al. 2020

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“…It is probable that the absence of relevant differences between groups may be due to the fact that all of our patients had advanced stages of cirrhosis, where CAID is usually found, characterized by elevated immune activation, in ammation, and dysregulation of the immune system [4]. Additionally, Corma-Gómez et al [49] have recently reported that HIV coinfection is not related to a higher risk for developing liver complications in HCV-infected patients with advanced brosis, who achieved SVR with IFN-free regimens. Malin et al [50] observed that the LSM regression after successful DAA therapy did not differ in patients with HCV/HIV coinfection and those with HCV monoinfection.…”

Section: Discussionmentioning

confidence: 88%

Improvement of liver disease and inflammation in patients with advanced HCV-related cirrhosis after antiviral therapy

Medrano

Berenguer

Salgüero

et al. 2020

Preprint

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Eradication of hepatitis C virus (HCV) promotes an improvement in liver disease and deactivation of the immune system. Here, we aimed to evaluate the changes in liver disease scores and plasma biomarkers following HCV clearance with direct-acting antivirals (DAAs) in patients with advanced HCV-related cirrhosis. We performed a prospective study of patients with advanced cirrhosis (liver decompensation or liver stiffness measurement [LSM]≥25 kPa or hepatic liver pressure gradient [HVPG]≥10 mmHg or Child-Pugh-Turcotte (CTP)≥7) who received DAA therapy. Variables were assessed at baseline and 48 weeks after HCV treatment completion. Statistical analyses were performed employing Generalized Linear Mixed Models (GLMM). In this study, 62 patients (12 HCV-monoinfected and 50 HIV/HCV-coinfected) who achieved SVR were included in the analysis. We found significant decreases in LSM, HVPG, LBP, IP-10, IL-8, IL-1β, IL-18, IL-1RA, OPG, sVCAM-1, sICAM-1, TNFR-I, PAI-1, and VEF-A during follow-up. Variations in most outcome measures were similar as for HCV-monoinfected and HIV/HCV-coinfected patients. We found significant positive associations between changes in LBP, IP-10, MCP-1, IL-8, IL-1β, IL-18, IL-6, OPG, sVCAM-1, sICAM-1, and PAI-1 and LSM values after HCV clearance. We found variations in LBP, IL-8, IL-6, IL-18, OPG, PAI-1, and D-dimer were positively associated with changes in HVPG values; and variations in IP-10, IL-1β, IL-6, TNF-α, IL-1RA, OPG, and sICAM-1 were related to changes in CTP score. In conclusion, the eradication of HCV with all-oral DAAs promoted a decrease in the severity of advanced cirrhosis and plasma biomarkers (inflammation, coagulopathy, and angiogenesis), which were positively associated with each other.

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“…All the patients were Caucasian and HBsAg negative. Overall, median CD4+ cell count was 621 cells/mm 3 (IQR 443‐846 cells/mm 3 ) and median nadir value of 198 cells/mm 3 (IQR 87‐301 cells/mm 3 ): 59 (56.7%) were LLVp and 45 were Up (43.3%).The main viroimmunological characteristics and prescribed ART were comparable in the two groups of patients (Table 1); DAA regimen is described in Table S1. The interval between the last plasma HIV‐RNA testing and the start of anti‐HCV therapy was 4 weeks (median value, IQR 2‐5 weeks).…”

Section: Resultsmentioning

confidence: 97%

“…HCV infection promotes both a specific immune response against HCV and a nonspecific immune activation, which is more severe in HIV‐positive subjects: serum biomarkers of inflammation, bacterial translocation, and endothelial disfunction are significantly higher in case of HIV‐HCV coinfection with respect to HIV monoinfection and a significant decrease occurred in case of HCV clearance 1,2 . Once HCV is eradicated, the HIV involvement in the inflammatory process leading to liver fibrosis may disappear 3 . Low‐level plasma HIV viremia is a parameter that can be related to immune activation 4‐7 : the threshold value in copies/mL is object of great debate.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 Once HCV is eradicated, the HIV involvement in the inflammatory process leading to liver fibrosis may disappear. 3 Low-level plasma HIV viremia is a parameter that can be related to immune activation [4][5][6][7] : the threshold value in copies/mL is object of great debate. Lesko et al 8 reported in a recently published work that common choices below which HIV viral load will be considered suppressed are 20, 50, 200, or 400 copies/mL and even higher plasma HIV-RNA levels were reported.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Sustained virological response after treatment with direct‐acting antivirals can help immune reconstitution in HIV‐HCV coinfected patients even in case of persistent HIV low‐level viremia

Basso

Zago

Pozzetto

et al. 2020

Health Science Reports

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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

Cited by 19 publications

References 31 publications

Advanced liver disease outcomes after hepatitis C eradication by human immunodeficiency virus infection in PITER cohort

Advanced liver disease outcomes after hepatitis C eradication by human immunodeficiency virus infection in PITER cohort

Improvement of liver disease and inflammation in patients with advanced HCV-related cirrhosis after antiviral therapy

Sustained virological response after treatment with direct‐acting antivirals can help immune reconstitution in HIV‐HCV coinfected patients even in case of persistent HIV low‐level viremia

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