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Similar recovery of liver function after response to all‐oral HCV therapy in patients with cirrhosis with and without HIV coinfection
Author(s) -
Macías Juan,
Granados Rafael,
Téllez Francisco,
Merino Dolores,
Pérez Montserrat,
Morano Luis E.,
Palacios Rosario,
Paniagua María,
Frías Mario,
Merchante Nicolás,
Pineda Juan A.
Publication year - 2019
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.12990
Subject(s) - medicine , coinfection , gastroenterology , cirrhosis , liver function , hepatitis c , liver function tests , confidence interval , bilirubin , retrospective cohort study , cohort , human immunodeficiency virus (hiv) , immunology
Summary 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.