Impact of HIV infection on the dynamics of liver stiffness in patients with hepatitis C virus chronic infection after sustained virological response

Background After sustained virological response (SVR), liver stiffness (LS) usually decreases. However, information related to the impact of HIV co-infection in patients with advanced fibrosis is scarce. The aim was to analyze the impact of HIV co-infection on the LS dynamics after HCV cure. Methods...

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Detalles Bibliográficos
Autores: Martín Carmona, Jésica, Corma Gómez, Anaïs, Moyano Murillo, José María, Téllez Pérez, Francisco de Paula, Arenga Barrios, Dolores, Serrano Fuentes, Miriam, Morano Vázquez, Aitana Carla, Corona Mata, Diana, Navarrete Lorite, Miguel Nicolás, Vera Méndez, Francisco, Barroso, Isabel, Palacios, Rosario, Santos, Ignacio de los, Belinchón, Olga, Galera, Carlos, Imaz, Arkaitz, Merino, Dolores, Reus Bañuls, Sergio, Galindo, María José, López Zuñiga, Miguel Ángel, Pineda, Juan Antonio, Macías, Juan, GEHEP-011 Study Group
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/222075
Acceso en línea:https://hdl.handle.net/2445/222075
Access Level:acceso abierto
Palabra clave:Virus de l'hepatitis C
Infeccions per VIH
Hepatitis C virus
HIV infections
Descripción
Sumario:Background After sustained virological response (SVR), liver stiffness (LS) usually decreases. However, information related to the impact of HIV co-infection in patients with advanced fibrosis is scarce. The aim was to analyze the impact of HIV co-infection on the LS dynamics after HCV cure. Methods Prospective study conducted in the GEHEP-011 multicenter cohort (initiated in October 2011-November 2023, ID NCT04460157), including patients with chronic HCV infection, with or without HIV co-infection, fulfilling: 1) SVR with direct-acting antivirals; 2) pre-treatment LS >= 9.5 kPa; 3) available measurement of LS at SVR. Pre-treatment, SVR and annual post-treatment LS were assessed. The primary outcome was time to LS normalization achievement (<= 7.2 kPa) in two consecutive examinations. Findings 1138 patients were included, 678 (60%) of whom were living with HIV (PLWH). The median time between the first to the last measure was 35 (17-69) months. In total, 390 [34% (95% confidence interval, 31%-37%)] patients achieved LS normalization, 169 [37% (CI 95%, 34%-43%)] individuals with HCV mono-infection vs. 221 [32% (CI 95%, 29%-36%)] PLWH achieved LS normalization (p = 0.003). The propensity score (PS) for HIV infection was calculated. In a multivariate model for competing risks (death was the competing event) adjusted for HIV, PS and diabetes, HIV infection was associated with a lower probability of achieving normalization [sHR = 0.82 (95% CI, 0.67-1.00), p = 0.045]. Matching by closer PS was performed. In the resultant subset, the probability of achieving LS normalization was again lower in PLWH [sHR = 0.76 (0.56-0.97), p < 0.001]. Interpretation After SVR, the probability of reaching LS normalization is significantly lower in PLWH. This could have implications on the development of long-term clinical events. Copyright (c) 2025 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/).

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