Impact of peginterferon alpha-2b and ribavirin treatment on liver tissue in patients with HCV or HCV–HIV co-infection

Sarmento‐Castro, Rui; Horta, Ana; Vasconcelos, Olga; Coelho, H S; Méndez, Juan Vicente Méndez; Tavares, Ana Paula; Seabra, J.; Duarte, Manuela; Chaves, Leonor; Fortes, O.; Recalde, Cristina; Ventura, Annavera; Pires, Nuno; Pinho, Luciana; Dias, Nuno; Carneiro, Fátima

doi:10.1016/j.jinf.2006.11.010

Cited by 8 publications

(6 citation statements)

References 21 publications

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“…In this way, the influence of age in fibrosis regression observed in several studies [31], including this, supports the influence of HSC, as older age is associated with hyperplasia of HSC in animal models [32]. Although significantly lower, histological responses were obtained in an important proportion of patients who did not achieve SVR during treatment, as previously described [18,20]. This fact has been attributed to inflammation reduction, and it could be expected to be transient, with later worsening [33].…”

Section: Discussionsupporting

confidence: 84%

“…Although significantly lower, histological responses were obtained in an important proportion of patients who did not achieve SVR during treatment, as previously described . This fact has been attributed to inflammation reduction, and it could be expected to be transient, with later worsening .…”

Section: Discussionsupporting

confidence: 82%

“…Their baseline characteristics are shown in Table 1. In brief, 79% were male, mean age was 41.1 years, 29% had a prior AIDS-defining condition, the median baseline CD4+ cell count was 529 cells/mm 3 , 71% had an HIV RNA level below 50 copies/mL, the median time since HCV infection was 21 years (IQR, [18][19][20][21][22][23][24], and 51% were infected by HCV genotype 1. Liver biopsy was performed in 149 cases (69%) and TE in 67 patients before anti-HCV therapy was started, and it revealed that 49 patients (23%) had fibrosis 4 or cirrhosis.…”

Section: Resultsmentioning

confidence: 99%

“…In a small study including 67 monoinfected and 41 coinfected patients, fibrosis scores improved by 1 point in 42.5% of coinfected cases, without differences between HIV‐positive and HIV‐negative patients, but again histological assessment was performed 2 years after the end of interferon therapy . A similar outcome was observed in 47.0% of the coinfected patients who attained SVR .…”

Section: Discussionmentioning

confidence: 99%

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Regression of liver fibrosis is progressive after sustained virological response to HCV therapy in patients with hepatitis C and HIV coinfection

Casado¹,

Quereda²,

Moreno³

et al. 2013

Journal of Viral Hepatitis

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There are few data about the long-term histological outcome of HIV-/HCV-coinfected patients after therapy with interferon and ribavirin. We performed an observational study of 216 patients who received therapy against HCV and who had at least three successive transient elastographies (TE) during the follow-up. The primary endpoint was confirmed fibrosis regression, defined as a reduction of at least 1 point in Metavir fibrosis score, confirmed and without worsening in successive TE. At baseline, 23% had fibrosis stage 4 or cirrhosis. Overall, 82 (38%) achieved sustained virological response (SVR), without differences in baseline fibrosis or time of follow-up. Confirmed fibrosis regression was observed in 55% of patients, higher for SVR (71% vs 44%; P < 0.01), and the likelihood of achieving fibrosis regression at 3, 5 and 7 years was 0.17, 0.51 and 0.67, respectively, for SVR patients, in comparison with 0.02, 0.23 and 0.41 for no SVR patients (P < 0.01, log-rank test at any time point). Progressive regression, defined as continuous improvement in successive TE, was observed in 62% of patients with advanced liver fibrosis or cirrhosis who achieved SVR. In a Cox regression model, only SVR (HR, 4.01; 95% CI, 2.33-7.57; P < 0.01) and a younger age (HR, 1.14; 95% CI, 1.05-1.25; P < 0.01; per year) were associated with fibrosis regression. This study confirms that the rate of liver fibrosis regression increases during the follow-up after SVR to interferon therapy in HIV-/HCV-coinfected patients.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionsupporting

confidence: 82%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Regression of liver fibrosis is progressive after sustained virological response to HCV therapy in patients with hepatitis C and HIV coinfection

Casado¹,

Quereda²,

Moreno³

et al. 2013

Journal of Viral Hepatitis

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“…Specifically regarding HCC, Cammà et al [7,8] in 2001, pointed out that the benefit of the reduction in the incidence of HCC, albeit modest, is also more relevant among those who achieve an SVR after being treated with interferon alpha. Other authors have also reproduced data regarding the effective and tolerable treatment [11], fewer complications, reduction or negative incidence of HCC among cirrhotic patients monoinfected with HCV who achieved an SVR after the treatment with interferon alpha [12][13][14], and even histological response of patients co-infected with HIV [12]. Finally, even patients with severe cirrhosis under individualized, ascending-dose regimens benefit from treatment and can achieve an SVR, albeit a modest one [15][16][17].…”

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confidence: 89%

Maintenance treatment for the modulation of liver fibrosis

Araújo¹,

Barone²

2007

Braz J Infect Dis

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Similar Progression of Fibrosis Between HIV/HCV–Infected and HCV–Infected Patients: Analysis of Paired Liver Biopsy Samples

Sterling

Wegelin

Smith

et al. 2010

Clinical Gastroenterology and Hepatology

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Background and Aims Fibrosis progression might be accelerated in patients that are co-infected with HIV and hepatitis C virus (HIV/HCV). However, no studies have directly compared fibrosis progression by paired liver biopsy between patients infected with HIV and HCV vs. those infected with only HCV. Methods Liver biopsy samples were collected from patients with HIV/HCV (n=306) and those with HCV; biopsies from 59 without a sustained virologic response (SVR) or cirrhosis were matched with those from patients with only HCV (controls) for initial fibrosis stage, demographics, and HCV treatment. For HIV/HCV patients, categorical variables at baseline and the area under the curve of continuous variables per unit time were analyzed for associations with fibrosis progression. Results Liver biopsies from HIV/HCV patients had more piecemeal necrosis than controls (P=.001) and increased lobular inflammation (P=.002); HIV/HCV patients also had shorter intervals between liver biopsies (4.7 vs. 5.9 yrs, P<.0001). Between the 1st and 2nd biopsies, fibrosis remained unchanged or progressed 1 or 2 units in 55%, 18%, and 18% of HIV/HCV patients, respectively, compared with 45%, 30%, and 9% of controls. The fibrosis progression rate was similar between HIV/HCV and control patients (0.12±0.40 vs. 0.091±0.29 units/yr; P=.72). In paired biopsies from 66 patients, including those with SVR, there were no associations between fibrosis progression and demographics; numbers of CD4+ T cells; levels of aspartate aminotransferase or alanine aminotransferase; use of highly-active anti-retroviral therapy; response to HCV therapy (no treatment, SVR, or non-response); baseline levels of FIB-4; or histological features including inflammation, fibrosis, or steatosis. Conclusions Based on analysis of liver biopsy samples, fibrosis progression was similar between HIV/HCV- and HCV-infected patients; no clinical or laboratory parameters predicted disease progression.

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Impact of peginterferon alpha-2b and ribavirin treatment on liver tissue in patients with HCV or HCV–HIV co-infection

Cited by 8 publications

References 21 publications

Regression of liver fibrosis is progressive after sustained virological response to HCV therapy in patients with hepatitis C and HIV coinfection

Regression of liver fibrosis is progressive after sustained virological response to HCV therapy in patients with hepatitis C and HIV coinfection

Maintenance treatment for the modulation of liver fibrosis

Similar Progression of Fibrosis Between HIV/HCV–Infected and HCV–Infected Patients: Analysis of Paired Liver Biopsy Samples

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