DAAs therapy associated with improved hepatic fibrosis in HCV-GT4 patients co-infected with HIV

Expert Rev Gastroenterol Hepatol. 2019 Jul;13(7):693-698. doi: 10.1080/17474124.2019.1614441. Epub 2019 May 13.

Abstract

Background: The present work aimed at evaluation of the potential dynamic changes in hepatic fibrosis following treatment of chronic HCV using DAAs in patients coinfected with HIV. Patients and methods: In total, 50 HCV/HIV coinfected patients [age; 34.68 ± 10.38 years, 82% men] were included. For all included patients, liver stiffness measured using transient elastography as well as serum liver fibrosis scores; [fibrosis-4 (FIB-4) score and the aspartate aminotransferase to platelet ratio index (APRI)] were calculated at baseline and at 12 and 24-weeks following 12 weeks therapy of HCV with once daily sofosbuvir 400 mg plus daclatasvir 60 mg. Results: Most of the included patients (70%, n = 35) were on anti-retroviral therapy. SVR24 was achieved by 93.48% of the patients. There was significant serial improvement in baseline liver stiffness measurement (LSM), FIB-4 and APRI among responders; [LSM: baseline, 7.05 ± 4.84 kPa vs. 5.66 ± 2.63 kPa at SVR24, p < 0.001], [FIB-4: baseline, 1.24 ± 1.08 vs. 0.93 ± 0.64 at SVR24, p 0.001) and (APRI: baseline, 0.725 ± 0.66 vs. 0.36 ± 0.19at SVR24, p 0.001) respectively. Conclusion: Treatment of HCV patients coinfected with HIV using DAAs is associated with a rapid significant regression in hepatic fibrosis, as evaluated by FibroScan, FIB-4, and APRI scores.

Keywords: Hepatitis C virus; co-infection; direct acting antivirals; human immunodeficiency virus; liver fibrosis.

Publication types

  • Video-Audio Media

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use*
  • Antiviral Agents / therapeutic use*
  • Biomarkers / blood
  • Carbamates
  • Elasticity Imaging Techniques*
  • Female
  • HIV Infections / drug therapy*
  • Hepatitis C, Chronic / diagnostic imaging
  • Hepatitis C, Chronic / drug therapy*
  • Humans
  • Imidazoles / therapeutic use
  • Liver Cirrhosis / diagnostic imaging
  • Liver Cirrhosis / drug therapy*
  • Male
  • Prospective Studies
  • Pyrrolidines
  • Sofosbuvir / therapeutic use
  • Sustained Virologic Response
  • Valine / analogs & derivatives

Substances

  • Anti-HIV Agents
  • Antiviral Agents
  • Biomarkers
  • Carbamates
  • Imidazoles
  • Pyrrolidines
  • Valine
  • daclatasvir
  • Sofosbuvir