Clinical outcomes and prognostic factors after HCV clearance with DAA in HIV/HCV-coinfected patients with advanced fibrosis/cirrhosis.

Autor:	Berenguer J; Infectious Diseases/Clinical Microbiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain., Aldámiz-Echevarría T; Infectious Diseases/Clinical Microbiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain., Hontañón V; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.; HIV Unit/Internal Medicine, Hospital Universitario La Paz, Madrid, Spain.; Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain., Fanciulli C; Infectious Diseases/Clinical Microbiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain., Quereda C; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.; Infectious Diseases, Hospital Universitario Ramón y Cajal, Madrid, Spain.; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain., Busca C; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.; HIV Unit/Internal Medicine, Hospital Universitario La Paz, Madrid, Spain.; Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain., Domínguez L; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.; HIV Unit/Internal Medicine, Hospital Universitario 12 de Octubre, Madrid, Spain.; Instituto de Investigación Sanitaria Hospital 12 de Octubre (I+12), Madrid, Spain., Hernández C; Infectious Diseases/Internal Medicine, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain., Vergas J; Infectious Diseases/Internal Medicine, Hospital Clínico de San Carlos, Madrid, Spain.; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain., Gaspar G; Internal Medicine, Hospital Universitario de Getafe, Getafe, Spain., García-Fraile LJ; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.; Infectious Diseases, Hospital Universitario de la Princesa, Madrid, Spain.; Instituto de Investigación del Hospital de La Princesa (IIS-Princesa), Madrid, Spain., Díez C; Infectious Diseases/Clinical Microbiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain., De Miguel M; Fundación SEIMC-GeSIDA, Madrid, Spain., Bellón JM; Infectious Diseases/Clinical Microbiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain., Bañares R; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.; Departamento de Medicina Universidad Complutense, Madrid, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.; Liver Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain., González-García J; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.; HIV Unit/Internal Medicine, Hospital Universitario La Paz, Madrid, Spain.; Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain.
Jazyk:	angličtina
Zdroj:	Hepatology (Baltimore, Md.) [Hepatology] 2025 Jan 01; Vol. 81 (1), pp. 238-253. Date of Electronic Publication: 2024 Mar 07.
DOI:	10.1097/HEP.0000000000000838
Abstrakt:	Background and Aims: We assessed long-term clinical outcomes and prognostic factors for liver disease progression after sustained viral response with direct-acting antivirals in patients coinfected with HIV/HCV with advanced fibrosis or cirrhosis. Approach and Results: A total of 1300 patients who achieved sustained viral response with direct-acting antivirals from 2014 to 2017 in Spain were included: 1145 with compensated advanced chronic liver disease (384 advanced fibrosis and 761 compensated cirrhosis) and 155 with decompensated cirrhosis. The median follow-up was 40.9 months. Overall, 85 deaths occurred, 61 due to non-liver non-AIDS-related causes that were the leading cause of death across all stages of liver disease. The incidence (95% CI) of decompensation per 100 person-years (py) was 0 in patients with advanced fibrosis, 1.01 (0.68-1.51) in patients with compensated cirrhosis, and 8.35 (6.05-11.53) in patients with decompensated cirrhosis. The incidence (95% CI) of HCC per 100 py was 0.34 (0.13-0.91) in patients with advanced fibrosis, 0.73 (0.45-1.18) in patients with compensated cirrhosis, and 1.92 (1.00-3.70) per 100 py in patients with decompensated cirrhosis. Prognostic factors for decompensation in patients with compensated advanced chronic liver disease included serum albumin, liver stiffness measurement (LSM), and fibrosis 4. In this population, LSM and LSM-based posttreatment risk stratification models showed their predictive ability for decompensation and HCC. Conclusions: Non-liver non-AIDS-related events were the leading causes of morbidity and mortality after direct-acting antiviral cure among coinfected patients with advanced fibrosis/cirrhosis. Among those with compensated advanced chronic liver disease, baseline LSM and posttreatment LSM-based models helped to assess decompensation and HCC risk. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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