Liver function following hepatitis C virus eradication by direct acting antivirals in patients with liver cirrhosis: data from the PITER cohort
| Autor: | Quaranta M. G., Ferrigno L., Tata X., D'Angelo F., Coppola C., Ciancio A., Bruno S. R., Loi M., Giorgini A., Margotti M., Cossiga V., Brancaccio G., Dallio M., De Siena M., Cannizzaro M., Cavalletto L., Massari M., Mazzitelli M., De Leo P., Laccabue D., Baiocchi L., Kondili L. A., PITER Study Group, Federico A., Loguercio C. |
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| Přispěvatelé: | Quaranta, M. G., Ferrigno, L., Tata, X., D'Angelo, F., Coppola, C., Ciancio, A., Bruno, S. R., Loi, M., Giorgini, A., Margotti, M., Cossiga, V., Brancaccio, G., Dallio, M., De Siena, M., Cannizzaro, M., Cavalletto, L., Massari, M., Mazzitelli, M., De Leo, P., Laccabue, D., Baiocchi, L., Kondili, L. A., PITER Study, Group, Federico, A., Loguercio, C. |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Liver Cirrhosis
Male Cirrhosis Sustained Virologic Response HIV Infections Decompensated cirrhosis Hepacivirus Infectious and parasitic diseases RC109-216 medicine.disease_cause Direct-acting antiviral Direct-acting antivirals Gastroenterology Settore MED/12 Liver disease 0302 clinical medicine Liver Function Tests 030212 general & internal medicine Prospective Studies Prospective cohort study Advanced liver disease medicine.diagnostic_test Coinfection Hepatitis C virus Human immunodeficiency virus Hepatitis C Middle Aged Real-life cohort Aged Antiviral Agents Female Humans Treatment Outcome Infectious Diseases 030211 gastroenterology & hepatology medicine.medical_specialty Decompensated cirrhosi 03 medical and health sciences Internal medicine medicine Human immunodeficiency viru business.industry Research medicine.disease Liver function business Liver function tests Hepatitis C viru |
| Zdroj: | BMC Infectious Diseases, Vol 21, Iss 1, Pp 1-9 (2021) BMC Infectious Diseases |
| ISSN: | 1471-2334 |
| Popis: | Background The development of direct-acting antivirals (DAA) for HCV has revolutionized the treatment of HCV, including its treatment in patients with HIV coinfection. The aim of this study was to compare the changes in liver function between coinfected and monoinfected patients with cirrhosis who achieved HCV eradication by DAA. Methods Patients with pre-treatment diagnosis of HCV liver cirrhosis, consecutively enrolled in the multicenter PITER cohort, who achieved a sustained virological response 12 weeks after treatment cessation (SVR12) were analysed. Changes in Child-Pugh (C-P) class and the occurrence of a decompensating event was prospectively evaluated after the end of DAA treatment. Cox regression analysis was used to evaluate factors independently associated with changes in liver function following viral eradication. Results We evaluated 1350 patients, of whom 1242 HCV monoinfected (median follow-up 24.7, range 6.8–47.5 months after viral eradication) and 108 (8%) HCV/HIV coinfected (median follow-up 27.1, range 6.0–44.6). After adjusting for age, sex, HCV-genotype, HBsAg positivity and alcohol use, HIV was independently associated with a more advanced liver disease before treatment (C-P class B/C vs A) (OR: 3.73, 95% CI:2.00–6.98). Following HCV eradication, C-P class improved in 17/20 (85%) coinfected patients (from B to A and from C to B) and in 53/82 (64.6%) monoinfected patients (from B to A) (p = 0.08). C-P class worsened in 3/56 coinfected (5.3%) (from A to B) and in 84/1024 (8.2%) monoinfected patients (p = 0.45) (from A to B or C and from B to C). Baseline factors independently associated with C-P class worsening were male sex (HR = 2.00; 95% CI = 1.18–3.36), platelet count p = 0.83). Conclusions Improvement of liver function was observed following HCV eradication in the majority of patients with cirrhosis; however viral eradication did not always mean cure of liver disease in both monoinfected and coinfected patients with advanced liver disease. |
| Databáze: | OpenAIRE |
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