Hepatitis C Therapy Improves Liver Stiffness in HIV/HCV-Coinfected Patients

Hepatitis C virus (HCV)-related liver disease is accelerated in HIV settings, especially in patients with low CD4 counts, according to researchers.

However, a recent study conducted by French investigators shows a successful response to HCV therapy associated with a significant improvement in liver stiffness among people who are HIV/HCV-coinfected.

The study included 545 HIV/HCV-coninfected patients who were followed since 2004 and had longitudinal assessment of liver fibrosis by transient elastometry. The average age of the patients was 41 years, with 71% males, 81% having a prior history of intravenous drug use, and 8% having a prior history of alcohol abuse.

The patients were split into 5 groups based on exposure and response to peginterferon/ribavirin. Two examinations were considered for each patient.

The first was at six months into the study and the second at the end of follow-up. Among the 545 patients involved in the study, 498 fit study inclusion criteria and were examined.

Of the study population, 98 individuals had at least one pre-HCV therapy liver stiffness measurement of 7.1kPa or above, correlated with fibrosis stage F2. A significant regression in liver stiffness was defined as a 30% or more reduction from pre-treatment levels.

“A SVR (sustained virological response) to HCV therapy was independently associated with a decrease in liver stiffness,” the authors of the study wrote. “It is noteworthy that this decrease in liver stiffness occurred not only in patients with fibrosis but also in patients with cirrhosis.”

A median liver stiffness decreased in SVR groups, but in no other group involved in the study. People with SVR also had a 2.6-fold higher chance of experiencing a decrease in at least one fibrosis stage. At the two year follow-up interval, it was revealed that 68% of those with SVR had experienced regression to at least fibrosis stage F3, compared with 20% of people who did not have SVR.

“The therapeutic eradication of HCV induces rapid and durable regression of liver stiffness even in patients with cirrhosis,” concluded the investigators.

Further research is ongoing to evaluate if the decrease in liver stiffness is correlated with a reduced risk of serious liver disease, “even in patients with advanced disease and decompensated cirrhosis.”