Relationship of Liver Disease Stage and Antiviral Therapy With Liver-Related Events and Death in Adults Coinfected With HIV/HCV

Limketkai, Berkeley N.; Mehta, Shruti H.; Sutcliffe, Catherine G.; Higgins, Yvonne; Torbenson, Michael; Brinkley, Sherilyn; Moore, Richard D.; Thomas, David L.; Sulkowski, Mark S.

doi:10.1001/jama.2012.7844

Cited by 180 publications

(162 citation statements)

References 36 publications

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“…The risk of faster liver fibrosis progression among patients with higher LSM at baseline is consistent with the increased risk of clinical disease outcomes observed among patients with an initial higher fibrosis stage in a prospective cohort of more than 630 HIV/HCV-coinfected patients [34].…”

Section: Discussionsupporting

confidence: 74%

Liver stiffness and aspartate aminotransferase levels predict the risk for liver fibrosis progression in hepatitisCvirus/HIV‐coinfected patients

et al. 2014

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ObjectivesThe aim of the study was to investigate liver fibrosis outcome and the risk factors associated with liver fibrosis progression in hepatitis C virus (HCV)/HIV-coinfected patients. MethodsWe prospectively obtained liver stiffness measurements by transient elastography in a cohort of 154 HCV/HIV-coinfected patients, mostly Caucasian men on suppressive antiretroviral treatment, with the aim of determining the risk for liver stiffness measurement (LSM) increase and to identify the predictive factors for liver fibrosis progression. To evaluate LSM trends over time, a linear mixed regression model with LSM level as the outcome and duration of follow-up in years as the main covariate was fitted. ResultsAfter a median follow-up time of 40 months, the median increase in LSM was 1.05 kPa/year [95% confidence interval (CI) 0.72-1.38 kPa/year]. Fibrosis stage progression was seen in 47% of patients, and 17% progressed to cirrhosis. Aspartate aminotransferase (AST) levels and liver fibrosis stage at baseline were identified as independent predictors of LSM change. Patients with F3 (LSM 9.6-14.5 kPa) or AST levels ≥ 64 IU/L at baseline were at higher risk for accelerated LSM increase (ranging from 1.45 to 2.61 kPa/year), whereas LSM change was very slow among patients with both F0−F1 (LSM ≤ 7.5 kPa) and AST levels ≤ 64 IU/L at baseline (0.34 to 0.58 kPa/year). An intermediate risk for LSM increase (from 0.78 to 1.03 kPa/year) was seen in patients with F2 (LSM 7.6-9.5 kPa) and AST baseline levels ≤ 64 IU/L. ConclusionsAST levels and liver stiffness at baseline allow stratification of the risk for fibrosis progression and might be clinically useful to guide HCV treatment decisions in HIV-infected patients.Keywords: hepatitis C virus, HIV coinfection, liver fibrosis, liver stiffness, transient elastography IntroductionCoinfection with HIV and hepatitis C virus (HCV) is common, as HIV and HCV share similar routes of transmission.In Europe, approximately a third of patients who are HIVinfected are coinfected with HCV [1], and coinfection rates are as high as 60-95% among HIV-infected patients who have used injecting drugs or received blood transfusions [2][3][4]. Although sexual transmission of HCV is known to be rather inefficient in discordant heterosexual couples, recent observations suggest that this is the most likely mode of HCV acquisition among HIV-infected men who have sex The progression of HCV-associated liver fibrosis is accelerated among HIV-coinfected patients, and end-stage liver disease complications have emerged as the main cause of morbidity and mortality in this population [7,8]. Therefore, the recommendation to consider anti-HCV treatment in all HIV-coinfected patients [9] should be heeded, taking into account that HCV eradication prevents fibrosis progression [10,11] and leads to a decrease in both liver-related complications and mortality [10][11][12] as well as HIV progression and mortality not related to liver disease [13].However, the low chances of HCV eradication with the combination of interfe...

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Section: Discussionsupporting

confidence: 74%

Liver stiffness and aspartate aminotransferase levels predict the risk for liver fibrosis progression in hepatitisCvirus/HIV‐coinfected patients

et al. 2014

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“…Although successful treatment of chronic HCV-infection decreased liver-specific and all-cause mortality [5,6], rates of treatment uptake in the HIV-coinfected population were low [7]. Barriers to start treatment included comorbid medical and psychiatric conditions, active substance abuse with the inability to adhere to complex HCV treatment regimens, expected adverse effects of or contraindications for HCV combination therapy, and uncontrolled HIV disease (reviewed in [7]).…”

Section: Introductionmentioning

confidence: 99%

High hepatic and extrahepatic mortality and low treatment uptake in HCV-coinfected persons in the Swiss HIV cohort study between 2001 and 2013

Kovari¹,

Ledergerber²,

Cavassini³

et al. 2015

Journal of Hepatology

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“…Compared with HCV mono-infection, more rapid progression of chronic liver disease, prevalence of inflammatory and fibrotic expressed processes, and formation of cirrhosis at HIV/HCV co-infection have been observed in HCV and HIV co-infection [5][6][7][8][9]. In addition, the basic factors in the progression of chronic HCV include the Asian race, co-infection with HBV and HIV, age over 40 years, male sex, and alcohol abuse [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Comparative assessment of liver fibrosis in patients with HIV/chronic hepatitis C co-infection in different ethnic groups

Sarsekeyeva

Кошерова

Azizov

2016

J Infect Dev Ctries

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Introduction: In recent years, the frequency of human immunodeficiency virus (HIV) and hepatitis C (HCV) co-infection has increased, which is due to their common routes of transmission. HIV/chronic HCV co-infection aggravates the development of fibrosis and increases the risk of cirrhosis. The aim of the study was to evaluate the results of liver elastometry in patients of different ethnic groups with HIV/chronic HCV co-infection. Methodology: The study involved 49 Kazakh and 46 Russian patients with HIV/chronic HCV co-infection. The stage of liver fibrosis was assessed by the results of indirect ultrasonic liver elastometry according to the METAVIR scale using FibroScan 502. As an indirect marker of liver fibrosis, level of alanine aminotransferase and aspartate aminotransferase, as well as platelet counts, were determined. Results: Analysis of the results with the evaluation of the dynamics of fibrotic process in 36 months revealed a prevalence of patients with advanced liver fibrosis (F3, F4) among Kazakh compared with Russian patients, accompanied by a significant increase of liver elasticity indices in Kazakhs and Russians (p < 0.05). Significant differences in the indices of transaminases in the patients with later stages of liver fibrosis (F3, F4) were found (p < 0.05). Conclusions: The study of patients with HIV/chronic HCV co-infection revealed differences in the progression of liver fibrosis depending on ethnicity. Results of elastometry and indirect markers of liver fibrosis were used in the comprehensive assessment at different stages of liver fibrosis.

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Relationship of Liver Disease Stage and Antiviral Therapy With Liver-Related Events and Death in Adults Coinfected With HIV/HCV

Cited by 180 publications

References 36 publications

Liver stiffness and aspartate aminotransferase levels predict the risk for liver fibrosis progression in hepatitisCvirus/HIV‐coinfected patients

Liver stiffness and aspartate aminotransferase levels predict the risk for liver fibrosis progression in hepatitisCvirus/HIV‐coinfected patients

High hepatic and extrahepatic mortality and low treatment uptake in HCV-coinfected persons in the Swiss HIV cohort study between 2001 and 2013

Comparative assessment of liver fibrosis in patients with HIV/chronic hepatitis C co-infection in different ethnic groups

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