Effects of Hepatitis C Virus (HCV) Eradication on Bone Mineral Density in Human Immunodeficiency Virus/HCV-Coinfected Patients

Background: Little is known about the effects of eradication of hepatitis C virus (HCV) on bone mineral density (BMD) and biomarkers of bone remodeling in human immunodeficiency virus (HIV)/HCV-coinfected patients. Methods: We prospectively assessed standardized BMD (sBMD) at the lumbar spine and fe...

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Detalles Bibliográficos
Autores: Carrero, Ana, Berenguer, Juan, Hontañón, Víctor, Guardiola, Josep M, Navarro, Jordi, Von Wichmann, Miguel A, Téllez, María Jesús, Quereda, Carmen, Santos, Ignacio, Sanz, José, Galindo, María J, Hernández-Quero, José, Jimenez-Sousa, Maria Angeles, Pérez-Latorre, Leire, Bellón, José María, Resino, Salvador, Esteban, Herminia, Martínez, Esteban, González-García, Juan
Tipo de recurso: artículo
Fecha de publicación:2020
País:España
Institución:Instituto de Salud Carlos III (ISCIII)
Repositorio:Repisalud
Idioma:inglés
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/11087
Acceso en línea:http://hdl.handle.net/20.500.12105/11087
Access Level:acceso abierto
Palabra clave:Antiviral Agents
Bone Density
Coinfection
HIV
HIV Infections
Hepacivirus
Hepatitis C
Interferon-alpha
Polyethylene Glycols
Recombinant Proteins
Ribavirin
Humans
Male
Middle Aged
Descripción
Sumario:Background: Little is known about the effects of eradication of hepatitis C virus (HCV) on bone mineral density (BMD) and biomarkers of bone remodeling in human immunodeficiency virus (HIV)/HCV-coinfected patients. Methods: We prospectively assessed standardized BMD (sBMD) at the lumbar spine and femoral neck, World Health Organization BMD categories at both sites, and plasma concentrations of soluble receptor activator of NF-κβ ligand (sRANKL), and osteoprotegerin (OPG) at baseline (the date of initiation of anti-HCV therapy) and at 96 weeks. Results: A total of 238 patients were included. The median age was 49.5 years, 76.5% were males, 48.3% had cirrhosis, 98.3% were on antiretroviral therapy, median CD4+ cell count was 527 cells/μL, and 86.6% had HIV-1 RNA <50 copies/mL. The prevalence of osteoporosis at baseline at the lumbar spine (LS) and femoral neck (FN) was 17.6% and 7.2%, respectively. Anti-HCV therapy comprised pegylated interferon (peg-IFN) and ribavirin (RBV) plus 1 direct-acting antiviral in 53.4%, peg-IFN/RBV in 34.5%, and sofosbuvir/RBV in 12.2%. A total of 145 (60.9%) patients achieved sustained virologic response (SVR). No significant effect of SVR was observed on sBMD for the interaction between time and SVR either in the LS (P = .801) or the FN (P = .911). Likewise, no significant effect of SVR was observed in plasma levels of sRANKL (P = .205), OPG (P = .249), or sRANKL/OPG ratio (P = .123) for the interaction between time and SVR. No significant correlation was found between fibrosis by transient elastography, and LS and FN sBMD, at baseline and week 96. Conclusions: SVR was not associated with significant changes in BMD nor biomarkers of bone remodeling in HIV/HCV-coinfected persons.

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