RT Journal Article
T1 Sustained virological response to direct-acting antiviral regimens reduces the risk of hepatocellular carcinoma in HIV/HCV-coinfected patients with cirrhosis.
A1 Merchante, Nicolas
A1 Rivero-Juarez, Antonio
A1 Tellez, Francisco
A1 Merino, Dolores
A1 Rios-Villegas, Maria J
A1 Villalobos, Marina
A1 Omar, Mohamed
A1 Rincon, Pilar
A1 Rivero, Antonio
A1 Perez-Perez, Montserrat
A1 Raffo, Miguel
A1 Lopez-Montesinos, Inmaculada
A1 Palacios, Rosario
A1 Gomez-Vidal, Maria A
A1 Macias, Juan
A1 Pineda, Juan A
K1 Área de Gestión Sanitaria Campo de Gibraltar Oeste
K1 Área de Gestión Sanitaria Sur de Sevilla
K1 Incidence
K1 Liver cirrhosis
K1 Prospective studies
K1 Risk assessment
K1 Sustained virologic response
AB 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.
PB Oxford University Press
YR 2018
FD 2018-05-22
LK http://hdl.handle.net/10668/12691
UL http://hdl.handle.net/10668/12691
LA en
NO 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
DS RISalud
RD Apr 16, 2025