HLA-B18 as a risk factor of short-term progression to severe liver fibrosis in HIV/HCV co-infected patients with absent or minimal fibrosis: implications for timing of therapy.

ABSTRACT

Our aim was to analyze the influence of HLA-B haplotypes on liver fibrosis progression in HIV/hepatitis C virus (HCV) co-infected patients. Retrospective longitudinal study including HIV/HCV, non-cirrhotic and HCV treatment-naïve patients. The main outcome variable was liver fibrosis progression of at least one stage. One hundred and four patients constituted the study population (F0-F1 62 (59.6%); F2 22 (21.2%); F3 20 (19.2%)). During a median follow-up of 54.5 months (IQR 26.2-77), 45 patients (43.3%) showed an increase in the stage of liver fibrosis (time to event 29 (IQR 14-49.5) months). HLA-B18pos patients more frequently had a higher and faster fibrosis progression rate (73.3%; 24 (IQR 8-29) months) than HLA-B18neg patients (38.2%; 34.5 (IQR 14.7-51.2) months). This association was also observed in the development of F3-F4 fibrosis among F0-F2 patients (HLA-B18pos 69.2%; 18 (6.5-37) months vs HLA-B18neg 28.2%; 37 (IQR 19-52) months). These results could impact the timing of HCV therapy in F0-F2 patients.