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Similar recovery of liver function after response to all‐oral HCV therapy in patients with cirrhosis with and without HIV coinfection

AuthorsMacias, Juan; Granados, Rafael; Téllez, Francisco; Merino, Dolores; Pérez, Montserrat; Morano-Amado, Luis E.; Palacios, Rosario; Paniagua-García, María; Frías, Mario; Merchante, Nicolás; Pineda, Juan A.
Direct‐acting antiviral agents
Liver function parameters
Sustained virological response
Issue DateJan-2019
PublisherJohn Wiley & Sons
CitationJournal of Viral Hepatitis 26(1): 16-24 (2019)
AbstractAmong patients with cirrhosis, recovery of liver function after SVR to all‐oral direct‐acting antivirals (DAA ) in HIV /HCV coinfection could be different to that in HCV monoinfection. Because of this, we compared the changes in several markers of liver function between HCV ‐monoinfected and HIV /HCV ‐coinfected patients with cirrhosis who achieved SVR 12 to DAA combinations. In this retrospective cohort study, cirrhotics included in the HEPAVIR ‐DAA and GEHEP ‐MONO cohorts were selected if they had SVR 12 to all‐oral DAA s. Patients treated with atazanavir were excluded. Liver function improvement was defined as Child‐Pugh‐Turcotte (CPT ) decrease ≥1 and/or MELD decrease ≥2 between baseline and SVR 12. Liver function worsening was defined as a CPT increase ≥1 and/or MELD increase ≥2 and/or decompensations between baseline and SVR 12. We included 490 patients, 270 (55%) of them with HIV coinfection. Liver function improved in 50 (56%) HCV ‐infected individuals and in 82 (57%) HIV /HCV ‐coinfected patients (P = 0.835). Liver function worsened in 33 (15%) HCV ‐monoinfected patients and in 33 (13%) HIV /HCV ‐coinfected patients (P = 0.370). Factors independently related with liver function improvement were male gender [adjusted OR (AOR ) 2.1 (95% confidence interval, 95% CI : 1.03‐4.2), P = 0.040], bilirubin < 1.2 mg/dL (AOR 1.8 [95% CI : 1.004‐3.3], P = 0.49), and INR < 1.3 (AOR 2.4 [95% CI : 1.2‐5.0], P = 0.019) at baseline. After multivariate analysis, albumin < 3.5 g/dL was associated with liver function worsening (AOR 6.1 [95% CI : 3‐12.5], P < 0.001). Liver function worsening and improvement rates after responding to DAA are similar among HCV ‐monoinfected and HIV /HCV ‐coinfected cirrhotics. Gender, INR , bilirubin, and albumin levels were associated with liver function changes after response to DAA s.
Publisher version (URL)https://doi.org/10.1111/jvh.12990
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