Publication: Sustained virological response to direct-acting antiviral regimens reduces the risk of hepatocellular carcinoma in HIV/HCV-coinfected patients with cirrhosis.
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Identifiers
Date
2018-05-22
Authors
Merchante, Nicolas
Rivero-Juarez, Antonio
Tellez, Francisco
Merino, Dolores
Rios-Villegas, Maria J
Villalobos, Marina
Omar, Mohamed
Rincon, Pilar
Rivero, Antonio
Perez-Perez, Montserrat
Advisors
Journal Title
Journal ISSN
Volume Title
Publisher
Oxford University Press
Abstract
To assess the impact of all-oral direct-acting antiviral agent (DAA) regimens on the risk of hepatocellular carcinoma (HCC) in HIV/HCV-coinfected patients with cirrhosis. This was a multicentre prospective cohort study recruiting HIV/HCV-coinfected patients with a new diagnosis of compensated cirrhosis. Patients were followed up until HCC, death or the censoring date (March 2017). The primary endpoint was the emergence of HCC. The incidence rate (IR) (95% CI) of HCC in different groups was computed. Time-to-event analyses were performed to identify predictors of HCC emergence. The study included 495 HIV/HCV-coinfected patients with cirrhosis. After a median (IQR) follow-up of 59 (27-84) months, 22 (4.4%; 95% CI 2.6-6.3) patients developed an HCC. The IR (95% CI) of HCC was 0.93 (0.06-1.42) per 100 person-years (PY). Three hundred and three (61%) patients achieved sustained virological response (SVR) during follow-up, 79 after interferon (IFN)-based regimens and 224 after an all-oral DAA regimen. The IR (95% CI) of HCC after all-oral DAA was 0.35 (0.14-0.85) per 100 PY whereas it was 1.79 (1.11-2.88) per 100 PY in the remaining cohort (P = 0.0005). When only patients with SVR were considered, the IR (95% CI) of HCC after all-oral DAA was 0.32 (0.12-0.86) whereas it was 0 per 100 PY among those with SVR after IFN-based therapies (P = 0.27). Achieving SVR with an all-oral DAA regimen during follow-up was independently associated with a lower risk of HCC emergence (subhazard ratio 0.264; 95% CI 0.070-0.991; P = 0.049). SVR with all-oral DAA regimens reduces the risk of HCC in HIV/HCV-coinfected patients with compensated cirrhosis.
Description
MeSH Terms
Adult
Antiviral agents
Carcinoma, hepatocellular
Coinfection
Female
Follow-up studies
HIV infections
Hepatitis C, chronic
Humans
Male
Middle aged
Antiviral agents
Carcinoma, hepatocellular
Coinfection
Female
Follow-up studies
HIV infections
Hepatitis C, chronic
Humans
Male
Middle aged
DeCS Terms
Antivirales
Carcinoma hepatocelular
Coinfección
Estudios de seguimiento
Hepatitis C crónica
Infecciones por VIH
Carcinoma hepatocelular
Coinfección
Estudios de seguimiento
Hepatitis C crónica
Infecciones por VIH
CIE Terms
Keywords
Área de Gestión Sanitaria Campo de Gibraltar Oeste, Área de Gestión Sanitaria Sur de Sevilla, Incidence, Liver cirrhosis, Prospective studies, Risk assessment, Sustained virologic response
Citation
Merchante N, Rivero-Juárez A, Téllez F, Merino D, Ríos-Villegas MJ, Villalobos M, et al. Sustained virological response to direct-acting antiviral regimens reduces the risk of hepatocellular carcinoma in HIV/HCV-coinfected patients with cirrhosis. J Antimicrob Chemother. 2018 Sep 1;73(9):2435-2443
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Instituto de Investigación Biomédica de Sevilla (IBIS)
Instituto de Investigación Biomédica de Málaga - Plataforma Bionand (IBIMA)
Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)
SAS - Hospital de La Línea de La Concepción
SAS - Hospital Infanta Elena
SAS - Hospital Universitario de Jaén
Load more Instituto de Investigación Biomédica de Málaga - Plataforma Bionand (IBIMA)
Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)
SAS - Hospital de La Línea de La Concepción
SAS - Hospital Infanta Elena
SAS - Hospital Universitario de Jaén