Improvement of liver disease and inflammation in patients with advanced HCV-related cirrhosis after antiviral therapy

Abstract

Eradication of hepatitis C virus (HCV) promotes an improvement in liver disease and deactivation of the immune system. Here, we aimed to evaluate the changes in liver disease scores and plasma biomarkers following HCV clearance with direct-acting antivirals (DAAs) in patients with advanced HCV-related cirrhosis. We performed a prospective study of patients with advanced cirrhosis (liver decompensation or liver stiffness measurement [LSM]≥25 kPa or hepatic liver pressure gradient [HVPG]≥10 mmHg or Child-Pugh-Turcotte (CTP)≥7) who received DAA therapy. Variables were assessed at baseline and 48 weeks after HCV treatment completion. Statistical analyses were performed employing Generalized Linear Mixed Models (GLMM). In this study, 62 patients (12 HCV-monoinfected and 50 HIV/HCV-coinfected) who achieved SVR were included in the analysis. We found significant decreases in LSM, HVPG, LBP, IP-10, IL-8, IL-1β, IL-18, IL-1RA, OPG, sVCAM-1, sICAM-1, TNFR-I, PAI-1, and VEF-A during follow-up. Variations in most outcome measures were similar as for HCV-monoinfected and HIV/HCV-coinfected patients. We found significant positive associations between changes in LBP, IP-10, MCP-1, IL-8, IL-1β, IL-18, IL-6, OPG, sVCAM-1, sICAM-1, and PAI-1 and LSM values after HCV clearance. We found variations in LBP, IL-8, IL-6, IL-18, OPG, PAI-1, and D-dimer were positively associated with changes in HVPG values; and variations in IP-10, IL-1β, IL-6, TNF-α, IL-1RA, OPG, and sICAM-1 were related to changes in CTP score. In conclusion, the eradication of HCV with all-oral DAAs promoted a decrease in the severity of advanced cirrhosis and plasma biomarkers (inflammation, coagulopathy, and angiogenesis), which were positively associated with each other.

Successful HCV Therapy Reduces Liver Disease Severity and Inflammation Biomarkers in HIV/HCV-Coinfected Patients With Advanced Cirrhosis: A Cohort Study

“…We want to acknowledge the support of the Spanish HIV HGM BioBank for the collection of biological samples and their storage. This manuscript has been released as a pre-print at Medrano et al ( 51 ).…”