Advanced liver disease outcomes after hepatitis C eradication by human immunodeficiency virus infection in PITER cohort

Author:

Quaranta Maria Giovanna, ,Ferrigno Luigina,Monti Monica,Filomia Roberto,Biliotti Elisa,Iannone Andrea,Migliorino Guglielmo,Coco Barbara,Morisco Filomena,Vinci Maria,D’Ambrosio Roberta,Chemello Liliana,Massari Marco,Ieluzzi Donatella,Russo Francesco Paolo,Blanc Pierluigi,Verucchi Gabriella,Puoti Massimo,Rumi Maria Grazia,Barbaro Francesco,Santantonio Teresa Antonia,Federico Alessandro,Chessa Luchino,Gentile Ivan,Zuin Massimo,Parruti Giustino,Morsica Giulia,Kondili Loreta A.

Abstract

Abstract Background Liver disease progression after Hepatitis C Virus (HCV) eradication following direct-acting antiviral (DAA) treatment in the real-life setting according to Human Immunodeficiency Virus (HIV) coinfection was evaluated. Methods Patients consecutively enrolled in PITER between April 2014 and June 2019 and with at least 12-weeks follow-up following treatment were analysed. Cox regression analysis were used to evaluate HIV coinfection and factors independently associated with liver disease outcomes following viral eradication in DAA treated patients with pre-treatment liver cirrhosis. Results 93 HIV/HCV coinfected and 1109 HCV monoinfected patients were evaluated during a median follow-up of 26.7 (range 6–44.6) and 24.6 (range 6.8–47.3) months, respectively. No difference in the cumulative HCC incidence and hepatic decompensation was observed between coinfected and monoinfected patients. Age (Hazard Ratio [HR] = 1.08; 95% CI 1.04–1.13), male sex (HR = 2.76; 95% CI 1.28–5.96), lower albumin levels (HR = 3.94; 95% CI 1.81–8.58), genotype 3 (HR = 5.05; 95% CI 1.75–14.57) and serum anti-HBc positivity (HR = 1.99, 95% CI 1.01–3.95) were independently associated with HCC incidence. Older age (HR = 1.03; 95% CI 1.00–1.07), male sex (HR = 2.13; 95% CI 1.06–4.26) and lower albumin levels (HR = 3.75; 95% CI 1.89–7.46) were independently associated with the appearance of a decompensating event after viral eradication. Conclusion Different demographic, clinical and genotype distribution between HIV coinfected vs those monoinfected, was observed in a representative cohort of HCV infected patients in Italy. Once liver cirrhosis is established the disease progression is decreased, but still persists regardless of viral eradication in both coinfected and monoinfected patients. In patients with cirrhosis, HIV coinfection was not associated with a higher probability of liver complications, after viral eradication.

Funder

Ministero della Salute

Publisher

Springer Science and Business Media LLC

Subject

Hepatology

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