HCV eradication with all-oral therapy in cirrhotic HIV-coinfected patientsan observational study of early changes in liver function and fibrosis tests

  1. Lourdes Domínguez Domínguez 1
  2. Mariano Matarranz del Amo 1
  3. María de Lagarde Sebastián 1
  4. Otilia Bisbal Pardo 1
  5. María Asunción Hernando Jerez 1
  6. Carlos Lumbreras Bermejo 1
  7. Rafael Rubio 1
  8. Federico Pulido 1
  1. 1 Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12). Madrid, Spain
Revista:
Revista Española de Enfermedades Digestivas

ISSN: 2340-416,  1130-0108

Año de publicación: 2019

Volumen: 111

Número: 8

Páginas: 626-632

Tipo: Artículo

DOI: 10.17235/REED.2019.6086/2018 DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Revista Española de Enfermedades Digestivas

Objetivos de desarrollo sostenible

Resumen

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

Fuente de los datos: Dialnet