Changes in biomarkers of liver disease during successful combination antiretroviral therapy in HIV-HCV-coinfected individuals.

Détails

ID Serval
serval:BIB_8D6338AAE8DD
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Changes in biomarkers of liver disease during successful combination antiretroviral therapy in HIV-HCV-coinfected individuals.
Périodique
Antiviral Therapy
Auteur(s)
Rohrbach J., Stickel F., Schmid P., Thormann W., Kovari H., Scherrer A., Günthard H.F., Vuichard D., Cavassini M., Ambrosioni J., Bernasconi E., Furrer H., Rauch A.
Collaborateur(s)
Swiss HIV Cohort Study
ISSN
2040-2058 (Electronic)
ISSN-L
1359-6535
Statut éditorial
Publié
Date de publication
2014
Volume
19
Numéro
2
Pages
149-159
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Résumé
BACKGROUND: We investigated changes in biomarkers of liver disease in HIV-HCV-coinfected individuals during successful combination antiretroviral therapy (cART) compared to changes in biomarker levels during untreated HIV infection and to HIV-monoinfected individuals.
METHODS: Non-invasive biomarkers of liver disease (hyaluronic acid [HYA], aspartate aminotransferase-to-platelet ratio index [APRI], Fibrosis-4 [FIB-4] index and cytokeratin-18 [CK-18]) were correlated with liver histology in 49 HIV-HCV-coinfected patients. Changes in biomarkers over time were then assessed longitudinally in HIV-HCV-coinfected patients during successful cART (n=58), during untreated HIV-infection (n=59), and in HIV-monoinfected individuals (n=17). The median follow-up time was 3.4 years on cART. All analyses were conducted before starting HCV treatment.
RESULTS: Non-invasive biomarkers of liver disease correlated significantly with the histological METAVIR stage (P<0.002 for all comparisons). The mean ±sd area under the receiver operating characteristic (AUROC) curve values for advanced fibrosis (≥F3 METAVIR) for HYA, APRI, FIB-4 and CK-18 were 0.86 ±0.05, 0.84 ±0.08, 0.80 ±0.09 and 0.81 ±0.07, respectively. HYA, APRI and CK-18 levels were higher in HIV-HCV-coinfected compared to HIV-monoinfected patients (P<0.01). In the first year on cART, APRI and FIB-4 scores decreased (-35% and -33%, respectively; P=0.1), mainly due to the reversion of HIV-induced thrombocytopaenia, whereas HYA and CK-18 levels remained unchanged. During long-term cART, there were only small changes (<5%) in median biomarker levels. Median biomarker levels changed <3% during untreated HIV-infection. Overall, 3 patients died from end-stage liver disease, and 10 from other causes.
CONCLUSIONS: Biomarkers of liver disease highly correlated with fibrosis in HIV-HCV-coinfected individuals and did not change significantly during successful cART. These findings suggest a slower than expected liver disease progression in many HIV-HCV-coinfected individuals, at least during successful cART.
Mots-clé
Adult, Antiviral Agents/therapeutic use, Biological Markers, Coinfection, Drug Therapy, Combination, Drug-Induced Liver Injury/blood, Female, HIV Infections/blood, HIV Infections/drug therapy, Hepacivirus/genetics, Hepatitis C/blood, Hepatitis C/drug therapy, Humans, Male, Middle Aged
Pubmed
Création de la notice
14/01/2014 15:49
Dernière modification de la notice
21/08/2019 6:35
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