Human Immunodeficiency Virus (HIV) Infection Is Associated With Lower Risk of Hepatocellular Carcinoma After Sustained Virological Response to Direct-acting Antivirals in Hepatitis C Infected Patients With Advanced Fibrosis.

Autor:	Corma-Gómez, Anaïs, Macías, Juan, Lacalle-Remigio, Juan Ramón, Téllez, Francisco, Morano, Luis, Rivero, Antonio, Serrano, Miriam, Ríos, María José, Vera-Méndez, Francisco Jesús, Alados, Juan Carlos, Real, Luis Miguel, Palacios, Rosario, Santos, Ignacio De Los, Imatz, Arkaitz, Pineda, Juan Antonio, groups, RIS-HEP13 and GEHEP 011 study
Předmět:	HIV infection complications HIV infections CONFIDENCE intervals ANTIVIRAL agents CIRRHOSIS of the liver FISHER exact test MANN Whitney U Test RISK assessment T-test (Statistics) DESCRIPTIVE statistics CHI-squared test DATA analysis software HEPATOCELLULAR carcinoma LONGITUDINAL method DISEASE risk factors
Zdroj:	Clinical Infectious Diseases; 10/1/2021, Vol. 73 Issue 7, pe2109-e2116, 8p
Abstrakt:	Background The aim of this study was to assess the impact of human immunodeficiency virus (HIV) infection on the risk of developing hepatocellular carcinoma (HCC) in patients infected with hepatitis C virus (HCV) who achieve sustained virological response (SVR) with direct-acting antiviral (DAA). Methods Multisite prospective cohort study, where HCV-monoinfected patients and HIV/HCV-coinfected individuals were included if they met: (1) SVR with DAA-based combination; (2) liver stiffness (LS) ≥9.5 kPa previous to treatment; (3) LS measurement at the SVR time-point. The main endpoint was the occurrence of HCC. Propensity score (PS) was calculated to address potential confounders due to unbalanced distribution of baseline characteristics of HIV/HCV-coinfected and HCV-monoinfected patients. Results In total, 1035 HCV-infected patients were included, 667 (64%) coinfected with HIV. After a median (Q1–Q3) follow-up time of 43 (31–49) months, 19 (1.8%) patients developed HCC (11 [3.0%]; HCV-monoinfected, 8[1.2%]; HIV/HCV-coinfected individuals; P =.013). In the multivariable analysis, HIV coinfection was associated with a lower adjusted risk of developing HCC (subhazard ratio [sHR] = 0.27, 95% confidence interval [CI]:.08–.90; P =.034). Predictors of HCC emergence were: HCV genotype 3 (sHR = 7.9, 95% CI: 2.5–24.9; P <.001), MELD score at SVR >10 (sHR = 1.37, 95% CI: 1.01–1.86; P =.043) and LS value at SVR (sHR = 1.03, 95% CI: 1.01–1.06, for 1 kPa increase; P =.011). Using inverse probability weighting method on the PS, HIV-infected patients had a lower risk of HCC (powered HR = 0.33, 95% CI:.11–.85). Conclusions Among HCV-infected patients with advanced fibrosis, who achieve SVR with DAA, HIV coinfection seems to be associated with a lower risk of HCC occurrence. The underlying causes for this finding need to be investigated. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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