Similar recovery of liver function after response to all‐oral HCV therapy in patients with cirrhosis with and without HIV coinfection
| Autor: | Juan, Macías, Rafael, Granados, Francisco, Téllez, Dolores, Merino, Montserrat, Pérez, Luis E, Morano, Rosario, Palacios, María, Paniagua, Mario, Frías, Nicolás, Merchante, Juan A, Pineda, Carla, Toyas |
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| Přispěvatelé: | Junta de Andalucía, European Commission, Instituto de Salud Carlos III, Red Española de Investigación en SIDA |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Liver Cirrhosis
Male medicine.medical_specialty Cirrhosis HIV /HCV Administration Oral HIV Infections Direct‐acting antiviral agents Gastroenterology Antiviral Agents 03 medical and health sciences 0302 clinical medicine Sex Factors Liver Function Tests Virology Internal medicine medicine Humans 030212 general & internal medicine Prospective Studies Retrospective Studies Hepatology business.industry virus diseases Retrospective cohort study Middle Aged medicine.disease Hepatitis C Confidence interval digestive system diseases Atazanavir Liver function parameters Sustained virological response Infectious Diseases Liver Coinfection 030211 gastroenterology & hepatology Female Liver function business Viral hepatitis medicine.drug Cohort study |
| Zdroj: | Digital.CSIC. Repositorio Institucional del CSIC instname |
| Popis: | Among patients with cirrhosis, recovery of liver function after SVR to all‐oral direct‐acting antivirals (DAA ) in HIV /HCV coinfection could be different to that in HCV monoinfection. Because of this, we compared the changes in several markers of liver function between HCV ‐monoinfected and HIV /HCV ‐coinfected patients with cirrhosis who achieved SVR 12 to DAA combinations. In this retrospective cohort study, cirrhotics included in the HEPAVIR ‐DAA and GEHEP ‐MONO cohorts were selected if they had SVR 12 to all‐oral DAA s. Patients treated with atazanavir were excluded. Liver function improvement was defined as Child‐Pugh‐Turcotte (CPT ) decrease ≥1 and/or MELD decrease ≥2 between baseline and SVR 12. Liver function worsening was defined as a CPT increase ≥1 and/or MELD increase ≥2 and/or decompensations between baseline and SVR 12. We included 490 patients, 270 (55%) of them with HIV coinfection. Liver function improved in 50 (56%) HCV ‐infected individuals and in 82 (57%) HIV /HCV ‐coinfected patients (P = 0.835). Liver function worsened in 33 (15%) HCV ‐monoinfected patients and in 33 (13%) HIV /HCV ‐coinfected patients (P = 0.370). Factors independently related with liver function improvement were male gender [adjusted OR (AOR ) 2.1 (95% confidence interval, 95% CI : 1.03‐4.2), P = 0.040], bilirubin < 1.2 mg/dL (AOR 1.8 [95% CI : 1.004‐3.3], P = 0.49), and INR < 1.3 (AOR 2.4 [95% CI : 1.2‐5.0], P = 0.019) at baseline. After multivariate analysis, albumin < 3.5 g/dL was associated with liver function worsening (AOR 6.1 [95% CI : 3‐12.5], P < 0.001). Liver function worsening and improvement rates after responding to DAA are similar among HCV ‐monoinfected and HIV /HCV ‐coinfected cirrhotics. Gender, INR , bilirubin, and albumin levels were associated with liver function changes after response to DAA s. This study was partly supported by projects “PI15/01607” and “PI16/01443,” funded by Instituto de Salud Carlos III, integrated in the national I+D+i 2013‐2016, and cofunded by European Union (ERDF/ESF, “Investing in your future”) and by a grant from the Grupo para el Estudio de las Hepatitis Víricas (GEHEP) (grant GEHEP 001 2017). J.M. is the recipient of a grant from the Servicio Andaluz de Salud de la Junta de Andalucía (grant number B‐0037). J.A.P. is recipient of an intensification grant from the Instituto de Salud Carlos III (grant number Programa‐I3SNS). This work has been partially funded by the Spanish AIDS Research Network RD16/0025/0010 and RD16/0025/0034—ISCIII—FEDER. |
| Databáze: | OpenAIRE |
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