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Changes in liver fibrosis in HIV / HCV ‐coinfected patients following different outcomes with peginterferon plus ribavirin therapy
Author(s) -
Labarga P.,
FernandezMontero J. V.,
Barreiro P.,
Pinilla J.,
Vispo E.,
Mendoza C.,
Plaza Z.,
Soriano V.
Publication year - 2014
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.12180
Subject(s) - medicine , ribavirin , gastroenterology , hepatitis c , cohort , fibrosis , chronic hepatitis , liver fibrosis , immunology , virus
Summary There is scarce information about the impact of antiviral treatment on subsequent progression of liver fibrosis in HIV ‐infected patients with chronic hepatitis C who experience different outcomes following peginterferon‐ribavirin therapy. We conducted a retrospective study of a cohort of HIV / HCV ‐coinfected patients with longitudinal assessment of liver fibrosis using elastometry. Patients were split out into four groups according to the prior peginterferon‐ribavirin response: sustained virological response ( SVR ), relapse (R), partial response ( PR ) and null response ( NR ). A group of untreated, coinfected patients was taken as control. Significant liver fibrosis progression ( sLFP ) was defined as a shift from baseline Metavir estimates ≤F2 to F3‐F4, or by >30% increase in liver stiffness in patients with baseline F3‐F4. Conversely, significant liver fibrosis regression ( sLFR ) was defined as a shift from baseline Metavir estimates F3‐F4 to ≤F2, or by >30% reduction in liver stiffness in patients that kept on F3‐F4. A total of 498 HIV/HCV‐coinfected patients were examined. They were classified as follows: 138 (27.7%) SVR, 40 (8%) R, 61 (12.2%) PR, 71 (14.3%) NR and 188 (37.8%) naive. After a mean follow‐up of 53.3 months, sLFP occurred less frequently in patients with SVR (7.2%) compared with R (25%; P = 0.002), PR (23%; P = 0.002), NR (29.6%; P < 0.001) and naïve (19.7%; P = 0.002). Conversely, sLFR was 26.1% in SVR compared with 10% in R ( P = 0.03), 14.8% in PR ( P = 0.06), 16.9% in NR ( P = 0.07) and 10.6% in naïve ( P < 0.001). Sustained clearance of serum HCV ‐ RNA following a course of antiviral treatment is the major determinant of liver fibrosis regression in HIV / HCV ‐coinfected patients.