Author(s): Labarga P, FernandezMontero JV, Barreiro P, Pinilla J, Vispo E, , Labarga P, FernandezMontero JV, Barreiro P, Pinilla J, Vispo E,
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Abstract 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. © 2013 John Wiley & Sons Ltd.
This article was published in J Viral Hepat
and referenced in Journal of AIDS & Clinical Research