Progression of liver fibrosis following acute hepatitis C virus infection in HIV-positive MSM.
AIDS
; 33(5): 833-844, 2019 04 01.
Article
em En
| MEDLINE
| ID: mdl-30649050
ABSTRACT
BACKGROUND:
Whether continued, accelerated liver fibrosis progression occurs following acute hepatitis C virus infection (AHCVI) in HIV-positive MSM is unknown. DESIGN ANDMETHODS:
HIV-positive MSM from the AIDS Therapy Evaluation in the Netherlands and MSM Observational Study for Acute Infection with Hepatitis C-cohorts with primary AHCVI and at least one fibrosis-4 (FIB-4) measurement less than 2 years before and 1 year after estimated AHCVI were included. Mixed-effect linear models were used to evaluate (time-updated) determinants of FIB-4 levels over time. Determinants of transitioning to and from FIB-4 ≤â1.45 and >â1.45 were examined using multistate Markov models.RESULTS:
Of 313 MSM, median FIB-4 measurements per individual was 12 (interquartile range â=â8-18) and median follow-up following AHCVI was 3.5 years (interquartile rangeâ=â1.9-5.6). FIB-4 measurements averaged at 1.00 [95% confidence interval (CI)â=â0.95-1.05] before AHCVI, 1.31 (95% CIâ=â1.25-1.38) during the first year of AHCVI and 1.10 (95% CIâ=â1.05-1.15) more than 1 year after AHCVI. Mean FIB-4 more than 1 year after AHCVI was higher for chronically infected patients compared with those successfully treated (Pâ=â0.007). Overall FIB-4 scores were significantly higher with older age, lower CD4 cell count, longer duration from HIV-diagnosis or AHCVI, and nonresponse to HCV-treatment. At the end of follow-up, 60 (19.2%) and eight MSM (2.6%) had FIB-4 between 1.45-3.25 and ≥â3.25, respectively. Older age, lower CD4 cell count and detectable HIV-RNA were significantly associated with higher rates of progression to FIB-4 >â1.45, whereas older age, longer duration from HIV-diagnosis and nonresponse to HCV-treatment were significantly associated with lower rates of regression to FIB-4 ≤â1.45.CONCLUSION:
In this population of HIV-positive MSM, FIB-4 scores were higher during the first year of AHCVI, but FIB-4 ≥â3.25 was uncommon by the end of follow-up. Well controlled HIV-infection appears to attenuate FIB-4 progression.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
/
2_ODS3
Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
/
Hepatite C
/
Homossexualidade Masculina
/
Progressão da Doença
/
Coinfecção
/
Cirrose Hepática
Tipo de estudo:
Etiology_studies
/
Health_economic_evaluation
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Humans
/
Male
País/Região como assunto:
Europa
Idioma:
En
Revista:
AIDS
Ano de publicação:
2019
Tipo de documento:
Article