Year 2019 / Volume 111 / Number 8
Original
HCV eradication with all-oral therapy in cirrhotic HIV-coinfected patients: an observational study of early changes in liver function and fibrosis tests

626-632

DOI: 10.17235/reed.2019.6086/2018

Lourdes Domínguez Domínguez, Mariano Matarranz, María Lagarde, Otilia Bisbal, Asunción Hernando, Carlos Lumbreras, Rafael Rubio, Federico Pulido,

Abstract
Introduction: liver laboratory tests improve in hepatitis C virus (HCV)-monoinfected and cirrhotic patients who achieve HCV cure after interferon-free treatment. Objective and methods: this study evaluates the changes in those tests in human immunodeficiency virus (HIV)-positive subjects with an eradicated HCV-coinfection using direct-acting antivirals and with a pre-therapy liver stiffness ≥ 14.6 kPa or clinical data of cirrhosis. Serum albumin, bilirubin, creatinine, platelet count and international normalized ratio (INR) values were collected at baseline, week 4, at the end of treatment and 24 weeks after the end-of-treatment. Fibrosis-4 score (FIB4) and Model for End-stage Liver Disease (MELD) score values were calculated and liver stiffness was estimated by transient elastography at baseline and 24 weeks after the end-of-treatment. The means were compared with the Student’s t test or the repeated measures ANOVA test. Results: direct-acting antivirals were prescribed to 131 HIV/HCV-coinfected cirrhotic patients. A sustained virological response was confirmed in 120 cases. Albumin, bilirubin and platelet count values improved in the entire population 24 weeks after the end-of-treatment. INR and MELD score values decreased when patients with atazanavir and/or acenocoumarol were excluded and liver fibrosis tests significantly diminished. Nine patients developed liver decompensation and there were three deaths. Conclusion: in conclusion, HCV eradication was associated with a short-term improvement in biochemical liver function and fibrosis tests in HIV-coinfected patients with cirrhosis, although clinical events still occur.
Share Button
New comment
Comments
No comments for this article
References
1. Maruoka D, Imazeki F, Arai M, et al. Longitudinal changes of the laboratory data of chronic hepatitis C patients with sustained virological response on long-term follow-up. J Viral Hepat 2012; 19: 97-104.
2. Poordad F, Schiff ER, Vierling JM, et al. Daclatasvir with sofosbuvir and ribavirin for hepatitis C virus infection with advanced cirrhosis or post-liver transplantation recurrence. Hepatology 2016; 63: 1493-1505.
3. Charlton M, Everson GT, Flamm SL, et al. Ledipasvir and Sofosbuvir Plus Ribavirin for Treatment of HCV Infection in Patients with Advanced Liver Disease. Gastroenterology 2015; 149: 649-59.
4. Manns M, Samuel D, Gane EJ, et al. Ledipasvir and sofosbuvir plus ribavirin in patients with genotype 1 or 4 hepatitis C virus infection and advanced liver disease: a multicentre, open-label,randomized, phase 2 trial. Lancet Infect Dis 2016; 16: 685-97.
5. Curry MP, O’Leary JG, Bzowej N, et al. Sofosbuvir and Velpatasvir for HCV in Patients with Decompensated Cirrhosis. N Engl J Med 2015; 373: 2618-28.
6. Belli LS, Berenguer M, Cortesi PA, et al. Delisting of liver transplant candidates with chronic hepatitis C after viral eradication: A European study. J Hepatol 2016; 65: 524-31.
7. Van der Meer AJ, Berenguer M. Reversion of disease manifestations after HCV eradication. J Hepatol 2016; 65: S95-108.
8. Foster GR, Irving WL, Cheung MC, et al. Impact of direct-acting antiviral therapy in patients with chronic hepatitis C and decompensated cirrhosis. J Hepatol 2016; 64: 1224-31.
9. Cheung MCM, Walker AJ, Hudson BE, et al. Outcomes after successful direct-acting antiviral therapy for patients with chronic hepatitis C and decompensated cirrhosis. J Hepatol 2016; 65: 741-47.
10. Deterding K, Höner Zu Siederdissen C, Port K, et al. Improvement of liver function parameters in advanced HCV-associated liver cirrhosis by IFN-free antiviral therapies. Aliment Pharmacol Ther 2015; 42: 889-901.
11. Chekuri S, Nickerson J, Bichoupan K, et al. Liver Stiffness Decreases Rapidly in Response to Successful Hepatitis C Treatment and then Plateaus. PLoS One 2016; 11:e0159413.
12. Macías J, del Valle J, Rivero A, et al. Changes in liver stiffness in patients with chronic hepatitis C with and without HIV co-infection treated with pegylated interferon plus ribavirin. J Antimicrob Chemother 2010; 65: 2204–11.
13. ANRS CO13 HEPAVIH Cohort. Regression of liver stiffness after sustained hepatitis C virus (HCV) virological responses among HIV/HCV-coinfected patients. AIDS 2015; 29: 1821-30.
14. Bachofner JA, Valli PV, Kröger A, et al. Direct antiviral agent treatment of chronic hepatitis C results in rapid regression of transient elastography and fibrosis markers fibrosis- 4 score and aspartate aminotransferase- platelet ratio index. Liver Int 2017; 37: 369–76.
15. Alejos B, Hernando V, Iribarren J, et al. Overall and cause-specific excess mortality in HIV-positive persons compared with the general population. Medicine 2016; 95:36(e4727).
16. Vergara S, Macías J, Rivero A, et al. The Use of Transient Elastometry for Assessing Liver Fibrosis in Patients with HIV and Hepatitis C Virus Coinfection. CID 2007; 45: 969-74.
17. Castera L, Forns X, Alberti A. Non-invasive evaluation of liver fibrosis using transient elastography. J Hepatol 2008; 48: 835-47.
18. Culley CL, Kiang TK, Gilchrist SE, et al. Effect of the UGT1A1*28 Allele on Unconjugated Hyperbilirubinemia in HIV-Positive Patients Receiving Atazanavir: A Systematic Review. Ann Pharmacother 2013; 47: 561-72.
19. El-Sherif O, Khoo S, Solas C. Key drug–drug interactions with direct-acting antiviral in HIV–HCV coinfection. Curr Opin HIV AIDS 2015; 10: 348-54.
20. Pascasio JM, Vinaixa C, Ferrer MT, et al. Clinical outcomes of patients undergoing antiviral therapy while awaiting liver transplantation. J Hepatol 2017; 67: 1168-76.
21. Perricone G, Duvoux C, Berenguer M, et al. Deslisting HCV infected Liver Transplant Candidates who improved after Viral Eradication: Outcomes 2 Years after Delisting. Liver Int 2018. [ePub ahead of print]. doi: 10.1111/liv.13878.
22. Daniel KE, Said A. Considerations When Treating Hepatitis C in a Cirrhotic Transplant Candidate. Curr Gastroenterol Rep 2018; 20: 20. doi: 10.1007/s11894-018-0626-9.
23. Singh S, Facciorusso A, Loomba R, et al. Magnitude and Kinetics of Decrease in Liver Stiffness After Antiviral Therapy in Patients With Chronic Hepatitis C: A Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol 2018; 16: 27-38.
24. Fabbri G, Mastrorosa I, Vergori A, et al. Liver stiffness reduction and serum fibrosis score improvement in HIV/hepatitis C virus-coinfected patients treated with direct-acting antivirals. HIV Med 2018. [ePub ahead of print]. doi: 10.1111/hiv.12632.
25. Sterling RK, Lissen E, Clumeck N, et al. Development of a Simple Noninvasive Index to Predict Significant Fibrosis in Patients With HIV/HCV Coinfection. Hepatology 2006; 43: 1317-25.
26. Berenguer J, Rodríguez-Castellano E, Carrero A, et al. Eradication of Hepatitis C Virus and Non-Liver-Related Non–Acquired Immune Deficiency Syndrome–Related Events in Human Immunodeficiency Virus/Hepatitis C Virus Coinfection. Hepatology 2017; 66: 344-56.
Related articles
Citation tools
Domínguez Domínguez L, Matarranz M, Lagarde M, Bisbal O, Hernando A, Lumbreras C, et all. HCV eradication with all-oral therapy in cirrhotic HIV-coinfected patients: an observational study of early changes in liver function and fibrosis tests. 6086/2018


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 1018 visits.
This article has been downloaded 165 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 02/12/2018

Accepted: 22/02/2019

Online First: 26/06/2019

Published: 31/07/2019

Article revision time: 73 days

Article Online First time: 206 days

Article editing time: 241 days


Share
This article has been rated by 1 readers.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology