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

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

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)362-372
JournalHepatology International
Volume14
Issue number3
DOIs
Publication statusPublished - 2020

Keywords

  • Advanced liver disease
  • Cirrhosis
  • Clinical outcomes
  • Coinfection
  • Direct-acting antivirals
  • Hepatitis C virus
  • Hepatocellular carcinoma
  • Human immunodeficiency virus
  • Real-life cohort
  • Sustained virological response
  • Viral eradication

ASJC Scopus subject areas

  • Hepatology

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    on behalf of PITER Collaborating Group, Quaranta, M. G., Ferrigno, L., Monti, M., Filomia, R., Biliotti, E., Iannone, A., Migliorino, G., Coco, B., Morisco, F., Vinci, M., D’Ambrosio, R., Chemello, L., Massari, M., Ieluzzi, D., Russo, F. P., Blanc, P., Verucchi, G., Puoti, M., ... Kondili, L. A. (2020). Advanced liver disease outcomes after hepatitis C eradication by human immunodeficiency virus infection in PITER cohort. Hepatology International, 14(3), 362-372. https://doi.org/10.1007/s12072-020-10034-0