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dc.contributor.authorCorma-Gómez, Anaïs-
dc.contributor.authorMacias, Juan-
dc.contributor.authorTéllez, Francisco-
dc.contributor.authorFreyre-Carrillo, C.-
dc.contributor.authorMorano-Amado, Luis E.-
dc.contributor.authorRivero-Juárez, Antonio-
dc.contributor.authorRíos-Villegas, María José-
dc.contributor.authorAlados, Juan Carlos-
dc.contributor.authorVera-Méndez, Francisco Jesús-
dc.contributor.authorMerchante, Nicolás-
dc.contributor.authorPalacios, Rosario-
dc.contributor.authorGranados, Rafael-
dc.contributor.authorMerino, Dolores-
dc.contributor.authorDe Los Santos, Ignacio-
dc.contributor.authorPineda, Juan A.-
dc.identifierdoi: 10.1093/cid/ciz1140-
dc.identifiere-issn: 1537-6591-
dc.identifierissn: 1058-4838-
dc.identifier.citationClinical Infectious Diseases (2020)-
dc.descriptionOn behalf of RIS-HEP13 and GEHEP 011 study groups. In Press.-
dc.description.abstract[Background] Some people living with hepatitis C virus (HCV) with sustained virological response (SVR) develop hepatic complications. Liver stiffness (LS) predicts clinical outcome in people living with human immunodeficiency virus (HIV) with active HCV coinfection, but information after SVR is lacking. We aimed to analyze the predictive ability of LS at SVR for liver complications in people living with HIV/HCV with advanced fibrosis treated with direct-acting antivirals (DAA). [Methods] In sum, 640 people living with HIV/HCV fulfilling the following criteria were included: (i) Achieved SVR with DAA-including regimen; (ii) LS ≥ 9.5 kPa before therapy; and (iii) LS measurement available at SVR. The primary endpoint was the occurrence of a liver complication—hepatic decompensation or hepatocellular carcinoma (HCC)—or requiring liver transplant after SVR. [Results] During a median (Q1–Q3) follow-up of 31.6 (22.7–36.6) months, 19 (3%) patients reached the primary endpoint. In the multivariate analysis, variables (subhazard ratio [SHR] [95% confidence interval]) associated with developing clinical outcomes were: prior hepatic decompensations (3.42 [1.28–9.12]), pretreatment CPT class B or C (62.5 [3.08–1246.42]) and MELD scores (1.37 [1.03–1.82]), CPT class B or C at SVR (10.71 [1.32–87.01]), CD4 cell counts <200/µL at SVR time-point (4.42 [1.49–13.15]), FIB-4 index at SVR (1.39 [1.13–1.70]), and LS at SVR (1.05 [1.02–1.08] for 1 kPa increase). None of the 374 patients with LS <14kPa at SVR time-point developed a liver complication or required hepatic transplant. [Conclusions] LS at the time of SVR after DAA therapy predicts the clinical outcome of people living with HIV/HCV with advanced fibrosis. These results suggest that LS measurement may be helpful to select candidates to be withdrawn from surveillance programs.-
dc.description.sponsorshipThis work was supported in part by the Instituto de Salud Carlos III (Project “P16/01443”), integrated in the national I+D+i 2013–2016 and co-funded by the European Union (European Regional Development Fund/European Social Fund, “Investing in your future”), by the Spanish Network for AIDS investigation (RIS) (www.red.es/redes/inicio) (RD16/0025/0040), as a part of the Nacional I+ D+I, ISCIII Subdirección General de Evaluación and the European Fund for Development of Regions (FEDER) and by GEHEP-Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (GEHEP-011 project). JAP has received a research extension grant from the Programa de Intensificación de la Actividad de Investigación del Servicio Nacional de Salud Carlos III (3SNS).-
dc.publisherOxford University Press-
dc.subjectHIV/HCV coinfection-
dc.subjectDirect-acting antivirals-
dc.subjectHepatocellular carcinoma-
dc.titleLiver stiffness at the time of sustained virological response predicts the clinical outcome in HIV/HCV-coinfected patients with advanced fibrosis treated with direct-acting antivirals-
dc.contributor.funderInstituto de Salud Carlos III-
dc.contributor.funderEuropean Commission-
dc.contributor.funderRed Española de Investigación en SIDA-
dc.contributor.funderSociedad Española de Enfermedades Infecciosas y Microbiología Clínica-
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