Jesica Martín-Carmona, Diana Corona-Mata, Francisco Téllez, Miguel Nicolás Navarrete Lorite, Isabel Barroso, Juan Carlos Alados, Rosario Palacios Muñoz, Ignacio de Los Santos, Francisco Jesús Vera-Méndez, Arkaitz Imaz, Miguel Raffo Márquez, Aitana Carla Morano Vázquez, María José Galindo, Olga Belinchón, Miriam Serrano Fuentes, Miguel Ángel López Zúñiga, Carlos Galera Peñaranda, Sergio Javier Reus-Bañuls, Juan A Pineda, Juan Macías, Anaïs Corma-Gómez
{"title":"HIV/HCV合并感染和晚期纤维化患者持续病毒学反应后的长期肝僵硬动态","authors":"Jesica Martín-Carmona, Diana Corona-Mata, Francisco Téllez, Miguel Nicolás Navarrete Lorite, Isabel Barroso, Juan Carlos Alados, Rosario Palacios Muñoz, Ignacio de Los Santos, Francisco Jesús Vera-Méndez, Arkaitz Imaz, Miguel Raffo Márquez, Aitana Carla Morano Vázquez, María José Galindo, Olga Belinchón, Miriam Serrano Fuentes, Miguel Ángel López Zúñiga, Carlos Galera Peñaranda, Sergio Javier Reus-Bañuls, Juan A Pineda, Juan Macías, Anaïs Corma-Gómez","doi":"10.1097/QAD.0000000000004357","DOIUrl":null,"url":null,"abstract":"<p><strong>Objetive: </strong>This study analyses liver stiffness (LS) dynamics in people living with HIV (PLWH) and advanced liver fibrosis who achieved SVR and assess factors associated with LS normalization or progression, after long-term follow-up.</p><p><strong>Design: </strong>Prospective multicentre cohort study.</p><p><strong>Methods: </strong>this study included individuals with HIV/HCV co-infection from the Spanish GEHEP-011 cohort, fulfilling: 1) pre-treatment LS≥9.5kPa; 2) sustained virological response (SVR) with direct-acting antiviral regimen; 3) available measurement of LS at SVR. Factors associated with LS normalization (achieving ≤7.2kPa in two consecutive measurement) and progression (increase of >20% LS at the last measurement available) were analysed.</p><p><strong>Results: </strong>678 patients were included. The median follow-up was 40 (17-71) months. The repeated measures ANOVA revealed a significant main effect of time on LS. Overall, 221 (32.6%) achieved normalization. Lower probability of normalization was associated with advanced liver disease [baseline LS: sHR = 0.26 (95% CI, 0.19-0.37), p < 0.001; liver decompensation before SVR: sHR = 0.22 (0.05-0.97), p < 0.001; baseline MELD score: sHR = 0.81 (0.69-0.94), p = 0.006]. LS progression occurred in 50 (7.4%). Progression was associated with higher baseline LS [sHR = 1.04 (1.01-1.07), p = 0.007], controlled attenuation parameter (CAP) [CAP≥280 dB/m: sHR = 2.94 (1.16-7.44)] and older age [sHR 1.06 (1.00-1.13), per year, p = 0.04].</p><p><strong>Conclusions: </strong>In PLWH, LS significantly decreases after HCV cure in the long-term, achieving values of ≤7.2kPa. In a substantial proportion of patients, LS remain stable or even increases. Older age and concomitant steatotic liver disease are associated with LS progression.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Long-term liver stiffness dynamics after sustained virological response in patients with HIV/HCV co-infection and advanced fibrosis.\",\"authors\":\"Jesica Martín-Carmona, Diana Corona-Mata, Francisco Téllez, Miguel Nicolás Navarrete Lorite, Isabel Barroso, Juan Carlos Alados, Rosario Palacios Muñoz, Ignacio de Los Santos, Francisco Jesús Vera-Méndez, Arkaitz Imaz, Miguel Raffo Márquez, Aitana Carla Morano Vázquez, María José Galindo, Olga Belinchón, Miriam Serrano Fuentes, Miguel Ángel López Zúñiga, Carlos Galera Peñaranda, Sergio Javier Reus-Bañuls, Juan A Pineda, Juan Macías, Anaïs Corma-Gómez\",\"doi\":\"10.1097/QAD.0000000000004357\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objetive: </strong>This study analyses liver stiffness (LS) dynamics in people living with HIV (PLWH) and advanced liver fibrosis who achieved SVR and assess factors associated with LS normalization or progression, after long-term follow-up.</p><p><strong>Design: </strong>Prospective multicentre cohort study.</p><p><strong>Methods: </strong>this study included individuals with HIV/HCV co-infection from the Spanish GEHEP-011 cohort, fulfilling: 1) pre-treatment LS≥9.5kPa; 2) sustained virological response (SVR) with direct-acting antiviral regimen; 3) available measurement of LS at SVR. Factors associated with LS normalization (achieving ≤7.2kPa in two consecutive measurement) and progression (increase of >20% LS at the last measurement available) were analysed.</p><p><strong>Results: </strong>678 patients were included. The median follow-up was 40 (17-71) months. The repeated measures ANOVA revealed a significant main effect of time on LS. Overall, 221 (32.6%) achieved normalization. Lower probability of normalization was associated with advanced liver disease [baseline LS: sHR = 0.26 (95% CI, 0.19-0.37), p < 0.001; liver decompensation before SVR: sHR = 0.22 (0.05-0.97), p < 0.001; baseline MELD score: sHR = 0.81 (0.69-0.94), p = 0.006]. LS progression occurred in 50 (7.4%). Progression was associated with higher baseline LS [sHR = 1.04 (1.01-1.07), p = 0.007], controlled attenuation parameter (CAP) [CAP≥280 dB/m: sHR = 2.94 (1.16-7.44)] and older age [sHR 1.06 (1.00-1.13), per year, p = 0.04].</p><p><strong>Conclusions: </strong>In PLWH, LS significantly decreases after HCV cure in the long-term, achieving values of ≤7.2kPa. In a substantial proportion of patients, LS remain stable or even increases. Older age and concomitant steatotic liver disease are associated with LS progression.</p>\",\"PeriodicalId\":7502,\"journal\":{\"name\":\"AIDS\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-09-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"AIDS\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/QAD.0000000000004357\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"AIDS","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/QAD.0000000000004357","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Long-term liver stiffness dynamics after sustained virological response in patients with HIV/HCV co-infection and advanced fibrosis.
Objetive: This study analyses liver stiffness (LS) dynamics in people living with HIV (PLWH) and advanced liver fibrosis who achieved SVR and assess factors associated with LS normalization or progression, after long-term follow-up.
Design: Prospective multicentre cohort study.
Methods: this study included individuals with HIV/HCV co-infection from the Spanish GEHEP-011 cohort, fulfilling: 1) pre-treatment LS≥9.5kPa; 2) sustained virological response (SVR) with direct-acting antiviral regimen; 3) available measurement of LS at SVR. Factors associated with LS normalization (achieving ≤7.2kPa in two consecutive measurement) and progression (increase of >20% LS at the last measurement available) were analysed.
Results: 678 patients were included. The median follow-up was 40 (17-71) months. The repeated measures ANOVA revealed a significant main effect of time on LS. Overall, 221 (32.6%) achieved normalization. Lower probability of normalization was associated with advanced liver disease [baseline LS: sHR = 0.26 (95% CI, 0.19-0.37), p < 0.001; liver decompensation before SVR: sHR = 0.22 (0.05-0.97), p < 0.001; baseline MELD score: sHR = 0.81 (0.69-0.94), p = 0.006]. LS progression occurred in 50 (7.4%). Progression was associated with higher baseline LS [sHR = 1.04 (1.01-1.07), p = 0.007], controlled attenuation parameter (CAP) [CAP≥280 dB/m: sHR = 2.94 (1.16-7.44)] and older age [sHR 1.06 (1.00-1.13), per year, p = 0.04].
Conclusions: In PLWH, LS significantly decreases after HCV cure in the long-term, achieving values of ≤7.2kPa. In a substantial proportion of patients, LS remain stable or even increases. Older age and concomitant steatotic liver disease are associated with LS progression.
期刊介绍：
Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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