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Advanced liver disease outcomes after hepatitis C eradication by human immunodeficiency virus infection in PITER cohort.
- Source :
-
Hepatology international [Hepatol Int] 2020 May; Vol. 14 (3), pp. 362-372. Date of Electronic Publication: 2020 Apr 11. - Publication Year :
- 2020
-
Abstract
- Background: Liver disease progression after Hepatitis C Virus (HCV) eradication following direct-acting antiviral (DAA) treatment in the real-life setting according to Human Immunodeficiency Virus (HIV) coinfection was evaluated.<br />Methods: Patients consecutively enrolled in PITER between April 2014 and June 2019 and with at least 12-weeks follow-up following treatment were analysed. Cox regression analysis were used to evaluate HIV coinfection and factors independently associated with liver disease outcomes following viral eradication in DAA treated patients with pre-treatment liver cirrhosis.<br />Results: 93 HIV/HCV coinfected and 1109 HCV monoinfected patients were evaluated during a median follow-up of 26.7 (range 6-44.6) and 24.6 (range 6.8-47.3) months, respectively. No difference in the cumulative HCC incidence and hepatic decompensation was observed between coinfected and monoinfected patients. Age (Hazard Ratio [HR] = 1.08; 95% CI 1.04-1.13), male sex (HR = 2.76; 95% CI 1.28-5.96), lower albumin levels (HR = 3.94; 95% CI 1.81-8.58), genotype 3 (HR = 5.05; 95% CI 1.75-14.57) and serum anti-HBc positivity (HR = 1.99, 95% CI 1.01-3.95) were independently associated with HCC incidence. Older age (HR = 1.03; 95% CI 1.00-1.07), male sex (HR = 2.13; 95% CI 1.06-4.26) and lower albumin levels (HR = 3.75; 95% CI 1.89-7.46) were independently associated with the appearance of a decompensating event after viral eradication.<br />Conclusion: Different demographic, clinical and genotype distribution between HIV coinfected vs those monoinfected, was observed in a representative cohort of HCV infected patients in Italy. Once liver cirrhosis is established the disease progression is decreased, but still persists regardless of viral eradication in both coinfected and monoinfected patients. In patients with cirrhosis, HIV coinfection was not associated with a higher probability of liver complications, after viral eradication.
- Subjects :
- Coinfection
Disease Progression
Female
Humans
Incidence
Italy epidemiology
Male
Middle Aged
Prognosis
Sustained Virologic Response
Antiviral Agents therapeutic use
Carcinoma, Hepatocellular pathology
Carcinoma, Hepatocellular physiopathology
Carcinoma, Hepatocellular virology
HIV Infections diagnosis
HIV Infections drug therapy
HIV Infections epidemiology
Hepatitis C, Chronic diagnosis
Hepatitis C, Chronic drug therapy
Hepatitis C, Chronic epidemiology
Liver physiopathology
Liver virology
Liver Cirrhosis diagnosis
Liver Cirrhosis physiopathology
Liver Cirrhosis virology
Liver Neoplasms pathology
Liver Neoplasms physiopathology
Liver Neoplasms virology
Subjects
Details
- Language :
- English
- ISSN :
- 1936-0541
- Volume :
- 14
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Hepatology international
- Publication Type :
- Academic Journal
- Accession number :
- 32279177
- Full Text :
- https://doi.org/10.1007/s12072-020-10034-0