Human Immunodeficiency Virus/Hepatitis C Virus (HCV) Co‐infected Patients With Cirrhosis Are No Longer at Higher Risk for Hepatocellular Carcinoma or End‐Stage Liver Disease as Compared to HCV Mono‐infected Patients
It is widely accepted that human immunodeficiency virus (HIV) infection is a risk factor for increased severity of hepatitis C virus (HCV) liver disease. However, owing to better efficacy and safety of combination antiretroviral therapy (cART), and increased access to HCV therapy, whether this condi...
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| Veröffentlicht in: | Hepatology (Baltimore, Md.) Md.), 2019-09, Vol.70 (3), p.939-954 |
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| creator | Salmon‐Ceron, Dominique Nahon, Pierre Layese, Richard Bourcier, Valérie Sogni, Philippe Bani‐Sadr, Firouze Audureau, Etienne Merchadou, Laurence Dabis, François Wittkop, Linda Roudot‐Thoraval, Françoise |
| description | It is widely accepted that human immunodeficiency virus (HIV) infection is a risk factor for increased severity of hepatitis C virus (HCV) liver disease. However, owing to better efficacy and safety of combination antiretroviral therapy (cART), and increased access to HCV therapy, whether this condition remains true is still unknown. Overall, 1,253 HCV mono‐infected patients and 175 HIV/HCV co‐infected patients with cirrhosis, included in two prospective French national cohorts (ANRS CO12 CirVir and CO13 HEPAVIH), were studied. Cirrhosis was compensated (Child‐Pugh A), without past history of complication, and assessed on liver biopsy. Incidences of liver decompensation (LD), hepatocellular carcinoma (HCC), and death according to HIV status were calculated by a Fine‐Gray model adjusted for age. Propensity score matching was also performed to minimize confounding by baseline characteristics. At baseline, HIV/HCV patients were younger (47.5 vs. 56.0 years; P |
| doi_str_mv | 10.1002/hep.30400 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2159324157</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2159324157</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3530-34003c9a81fd2a45da713e0f86cc2f066a6b6a9813982f24bdb78075a83f220a3</originalsourceid><addsrcrecordid>eNp1kc1u1DAUhS0EokNhwQugK7FpF-k4dn6XVRiaSgNU_JRldMexZ1wSO7UTqtnxCLwgG54EtyksEKxs-X733ON7CHke05OYUrbcyeGE04TSB2QRpyyPOE_pQ7KgLKdRGfPygDzx_opSWiaseEwOOE2zMkmKBflRTz0aOO_7ydhWKi20NGIPl9pNflnLAUc9ag_V_AJHdXV5DJX9-e27NkqKUbZwERhpRg-f9biDSju3sz70nDoJby2srdlKBzhCrbe7cHuv_RdQ1sGdvBWy66YOHVTohDa2Rwi1lWnDjA8jbiWs9dfQ9kp7iV4CBje2H9CF0aOFYAjeWPNPR0_JI4Wdl8_uz0Py6fXqY1VH63dn59XpOhI85TTiYXVclFjEqmWYpC3mMZdUFZkQTNEsw2yTYVmETRZMsWTTbvKC5ikWXDFGkR-So1l3cPZ6kn5seu1v_4VG2sk3LE5LzpI4zQP68i_0yk7OBHcNYwVnWcYSFqjjmRLOeu-kagane3T7JqbNbeZNyLy5yzywL-4Vp00v2z_k75ADsJyBG93J_f-Vmnp1MUv-AuumuXY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2283266242</pqid></control><display><type>article</type><title>Human Immunodeficiency Virus/Hepatitis C Virus (HCV) Co‐infected Patients With Cirrhosis Are No Longer at Higher Risk for Hepatocellular Carcinoma or End‐Stage Liver Disease as Compared to HCV Mono‐infected Patients</title><source>MEDLINE</source><source>Wiley Online Library Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Salmon‐Ceron, Dominique ; Nahon, Pierre ; Layese, Richard ; Bourcier, Valérie ; Sogni, Philippe ; Bani‐Sadr, Firouze ; Audureau, Etienne ; Merchadou, Laurence ; Dabis, François ; Wittkop, Linda ; Roudot‐Thoraval, Françoise</creator><creatorcontrib>Salmon‐Ceron, Dominique ; Nahon, Pierre ; Layese, Richard ; Bourcier, Valérie ; Sogni, Philippe ; Bani‐Sadr, Firouze ; Audureau, Etienne ; Merchadou, Laurence ; Dabis, François ; Wittkop, Linda ; Roudot‐Thoraval, Françoise ; ANRS CO12 CirVir and ANRS CO13 HEPAVIH study groups ; for the ANRS CO12 CirVir and ANRS CO13 HEPAVIH study groups</creatorcontrib><description>It is widely accepted that human immunodeficiency virus (HIV) infection is a risk factor for increased severity of hepatitis C virus (HCV) liver disease. However, owing to better efficacy and safety of combination antiretroviral therapy (cART), and increased access to HCV therapy, whether this condition remains true is still unknown. Overall, 1,253 HCV mono‐infected patients and 175 HIV/HCV co‐infected patients with cirrhosis, included in two prospective French national cohorts (ANRS CO12 CirVir and CO13 HEPAVIH), were studied. Cirrhosis was compensated (Child‐Pugh A), without past history of complication, and assessed on liver biopsy. Incidences of liver decompensation (LD), hepatocellular carcinoma (HCC), and death according to HIV status were calculated by a Fine‐Gray model adjusted for age. Propensity score matching was also performed to minimize confounding by baseline characteristics. At baseline, HIV/HCV patients were younger (47.5 vs. 56.0 years; P < 0.001), more frequently males (77.1% vs. 62.3%; P < 0.001), and had at baseline and at end of follow‐up similar rates of HCV eradication than HCV mono‐infected patients. A total of 80.4% of HIV/HCV patients had an undetectable HIV viral load. After adjustment for age, 5‐year cumulative incidences of HCC and decompensation were similar in HIV/HCV and HCV patients (8.5% vs. 13.2%, P = 0.12 and 12.8% vs. 15.6%, P = 0.40, respectively). Overall mortality adjusted for age was higher in HIV/HCV co‐infected patients (subhazard ratio [SHR] = 1.88; 95% confidence interval [CI], 1.15‐3.06; P = 0.011). Factors associated with LD and HCC were age, absence of sustained virological response, and severity of cirrhosis, but not HIV status. Using a propensity score matching 95 patients of each group according to baseline features, similar results were observed. Conclusion: In HCV‐infected patients with cirrhosis, HIV co‐infection was no longer associated with higher risks of HCC and hepatic decompensation. Increased mortality, however, persisted, attributed to extrahepatic conditions.</description><identifier>ISSN: 0270-9139</identifier><identifier>EISSN: 1527-3350</identifier><identifier>DOI: 10.1002/hep.30400</identifier><identifier>PMID: 30569448</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adult ; Age ; Anti-Retroviral Agents - therapeutic use ; Antiretroviral therapy ; Biopsy ; Carcinoma, Hepatocellular - epidemiology ; Carcinoma, Hepatocellular - pathology ; Carcinoma, Hepatocellular - virology ; Cirrhosis ; Cohort Studies ; Coinfection - epidemiology ; Coinfection - pathology ; Coinfection - virology ; Disease Progression ; End Stage Liver Disease - epidemiology ; End Stage Liver Disease - pathology ; End Stage Liver Disease - virology ; Eradication ; Female ; France ; Hepacivirus - pathogenicity ; Hepatitis ; Hepatitis C ; Hepatitis C, Chronic - diagnosis ; Hepatitis C, Chronic - drug therapy ; Hepatitis C, Chronic - epidemiology ; Hepatocellular carcinoma ; Hepatology ; HIV ; HIV Infections - drug therapy ; HIV Infections - epidemiology ; HIV Infections - pathology ; Human immunodeficiency virus ; Humans ; Kaplan-Meier Estimate ; Liver cancer ; Liver cirrhosis ; Liver Cirrhosis - epidemiology ; Liver Cirrhosis - pathology ; Liver Cirrhosis - virology ; Liver diseases ; Liver Neoplasms - epidemiology ; Liver Neoplasms - pathology ; Liver Neoplasms - virology ; Male ; Middle Aged ; Mortality ; Multivariate Analysis ; Prevalence ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Assessment ; Risk factors ; Survival Analysis ; Viral Load</subject><ispartof>Hepatology (Baltimore, Md.), 2019-09, Vol.70 (3), p.939-954</ispartof><rights>2018 by the American Association for the Study of Liver Diseases.</rights><rights>2019 by the American Association for the Study of Liver Diseases.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3530-34003c9a81fd2a45da713e0f86cc2f066a6b6a9813982f24bdb78075a83f220a3</citedby><cites>FETCH-LOGICAL-c3530-34003c9a81fd2a45da713e0f86cc2f066a6b6a9813982f24bdb78075a83f220a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fhep.30400$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fhep.30400$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,782,786,1419,27933,27934,45583,45584</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30569448$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Salmon‐Ceron, Dominique</creatorcontrib><creatorcontrib>Nahon, Pierre</creatorcontrib><creatorcontrib>Layese, Richard</creatorcontrib><creatorcontrib>Bourcier, Valérie</creatorcontrib><creatorcontrib>Sogni, Philippe</creatorcontrib><creatorcontrib>Bani‐Sadr, Firouze</creatorcontrib><creatorcontrib>Audureau, Etienne</creatorcontrib><creatorcontrib>Merchadou, Laurence</creatorcontrib><creatorcontrib>Dabis, François</creatorcontrib><creatorcontrib>Wittkop, Linda</creatorcontrib><creatorcontrib>Roudot‐Thoraval, Françoise</creatorcontrib><creatorcontrib>ANRS CO12 CirVir and ANRS CO13 HEPAVIH study groups</creatorcontrib><creatorcontrib>for the ANRS CO12 CirVir and ANRS CO13 HEPAVIH study groups</creatorcontrib><title>Human Immunodeficiency Virus/Hepatitis C Virus (HCV) Co‐infected Patients With Cirrhosis Are No Longer at Higher Risk for Hepatocellular Carcinoma or End‐Stage Liver Disease as Compared to HCV Mono‐infected Patients</title><title>Hepatology (Baltimore, Md.)</title><addtitle>Hepatology</addtitle><description>It is widely accepted that human immunodeficiency virus (HIV) infection is a risk factor for increased severity of hepatitis C virus (HCV) liver disease. However, owing to better efficacy and safety of combination antiretroviral therapy (cART), and increased access to HCV therapy, whether this condition remains true is still unknown. Overall, 1,253 HCV mono‐infected patients and 175 HIV/HCV co‐infected patients with cirrhosis, included in two prospective French national cohorts (ANRS CO12 CirVir and CO13 HEPAVIH), were studied. Cirrhosis was compensated (Child‐Pugh A), without past history of complication, and assessed on liver biopsy. Incidences of liver decompensation (LD), hepatocellular carcinoma (HCC), and death according to HIV status were calculated by a Fine‐Gray model adjusted for age. Propensity score matching was also performed to minimize confounding by baseline characteristics. At baseline, HIV/HCV patients were younger (47.5 vs. 56.0 years; P < 0.001), more frequently males (77.1% vs. 62.3%; P < 0.001), and had at baseline and at end of follow‐up similar rates of HCV eradication than HCV mono‐infected patients. A total of 80.4% of HIV/HCV patients had an undetectable HIV viral load. After adjustment for age, 5‐year cumulative incidences of HCC and decompensation were similar in HIV/HCV and HCV patients (8.5% vs. 13.2%, P = 0.12 and 12.8% vs. 15.6%, P = 0.40, respectively). Overall mortality adjusted for age was higher in HIV/HCV co‐infected patients (subhazard ratio [SHR] = 1.88; 95% confidence interval [CI], 1.15‐3.06; P = 0.011). Factors associated with LD and HCC were age, absence of sustained virological response, and severity of cirrhosis, but not HIV status. Using a propensity score matching 95 patients of each group according to baseline features, similar results were observed. Conclusion: In HCV‐infected patients with cirrhosis, HIV co‐infection was no longer associated with higher risks of HCC and hepatic decompensation. Increased mortality, however, persisted, attributed to extrahepatic conditions.</description><subject>Adult</subject><subject>Age</subject><subject>Anti-Retroviral Agents - therapeutic use</subject><subject>Antiretroviral therapy</subject><subject>Biopsy</subject><subject>Carcinoma, Hepatocellular - epidemiology</subject><subject>Carcinoma, Hepatocellular - pathology</subject><subject>Carcinoma, Hepatocellular - virology</subject><subject>Cirrhosis</subject><subject>Cohort Studies</subject><subject>Coinfection - epidemiology</subject><subject>Coinfection - pathology</subject><subject>Coinfection - virology</subject><subject>Disease Progression</subject><subject>End Stage Liver Disease - epidemiology</subject><subject>End Stage Liver Disease - pathology</subject><subject>End Stage Liver Disease - virology</subject><subject>Eradication</subject><subject>Female</subject><subject>France</subject><subject>Hepacivirus - pathogenicity</subject><subject>Hepatitis</subject><subject>Hepatitis C</subject><subject>Hepatitis C, Chronic - diagnosis</subject><subject>Hepatitis C, Chronic - drug therapy</subject><subject>Hepatitis C, Chronic - epidemiology</subject><subject>Hepatocellular carcinoma</subject><subject>Hepatology</subject><subject>HIV</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - epidemiology</subject><subject>HIV Infections - pathology</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Liver cancer</subject><subject>Liver cirrhosis</subject><subject>Liver Cirrhosis - epidemiology</subject><subject>Liver Cirrhosis - pathology</subject><subject>Liver Cirrhosis - virology</subject><subject>Liver diseases</subject><subject>Liver Neoplasms - epidemiology</subject><subject>Liver Neoplasms - pathology</subject><subject>Liver Neoplasms - virology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate Analysis</subject><subject>Prevalence</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk factors</subject><subject>Survival Analysis</subject><subject>Viral Load</subject><issn>0270-9139</issn><issn>1527-3350</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1u1DAUhS0EokNhwQugK7FpF-k4dn6XVRiaSgNU_JRldMexZ1wSO7UTqtnxCLwgG54EtyksEKxs-X733ON7CHke05OYUrbcyeGE04TSB2QRpyyPOE_pQ7KgLKdRGfPygDzx_opSWiaseEwOOE2zMkmKBflRTz0aOO_7ydhWKi20NGIPl9pNflnLAUc9ag_V_AJHdXV5DJX9-e27NkqKUbZwERhpRg-f9biDSju3sz70nDoJby2srdlKBzhCrbe7cHuv_RdQ1sGdvBWy66YOHVTohDa2Rwi1lWnDjA8jbiWs9dfQ9kp7iV4CBje2H9CF0aOFYAjeWPNPR0_JI4Wdl8_uz0Py6fXqY1VH63dn59XpOhI85TTiYXVclFjEqmWYpC3mMZdUFZkQTNEsw2yTYVmETRZMsWTTbvKC5ikWXDFGkR-So1l3cPZ6kn5seu1v_4VG2sk3LE5LzpI4zQP68i_0yk7OBHcNYwVnWcYSFqjjmRLOeu-kagane3T7JqbNbeZNyLy5yzywL-4Vp00v2z_k75ADsJyBG93J_f-Vmnp1MUv-AuumuXY</recordid><startdate>201909</startdate><enddate>201909</enddate><creator>Salmon‐Ceron, Dominique</creator><creator>Nahon, Pierre</creator><creator>Layese, Richard</creator><creator>Bourcier, Valérie</creator><creator>Sogni, Philippe</creator><creator>Bani‐Sadr, Firouze</creator><creator>Audureau, Etienne</creator><creator>Merchadou, Laurence</creator><creator>Dabis, François</creator><creator>Wittkop, Linda</creator><creator>Roudot‐Thoraval, Françoise</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TM</scope><scope>7TO</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201909</creationdate><title>Human Immunodeficiency Virus/Hepatitis C Virus (HCV) Co‐infected Patients With Cirrhosis Are No Longer at Higher Risk for Hepatocellular Carcinoma or End‐Stage Liver Disease as Compared to HCV Mono‐infected Patients</title><author>Salmon‐Ceron, Dominique ; Nahon, Pierre ; Layese, Richard ; Bourcier, Valérie ; Sogni, Philippe ; Bani‐Sadr, Firouze ; Audureau, Etienne ; Merchadou, Laurence ; Dabis, François ; Wittkop, Linda ; Roudot‐Thoraval, Françoise</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3530-34003c9a81fd2a45da713e0f86cc2f066a6b6a9813982f24bdb78075a83f220a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Age</topic><topic>Anti-Retroviral Agents - therapeutic use</topic><topic>Antiretroviral therapy</topic><topic>Biopsy</topic><topic>Carcinoma, Hepatocellular - epidemiology</topic><topic>Carcinoma, Hepatocellular - pathology</topic><topic>Carcinoma, Hepatocellular - virology</topic><topic>Cirrhosis</topic><topic>Cohort Studies</topic><topic>Coinfection - epidemiology</topic><topic>Coinfection - pathology</topic><topic>Coinfection - virology</topic><topic>Disease Progression</topic><topic>End Stage Liver Disease - epidemiology</topic><topic>End Stage Liver Disease - pathology</topic><topic>End Stage Liver Disease - virology</topic><topic>Eradication</topic><topic>Female</topic><topic>France</topic><topic>Hepacivirus - pathogenicity</topic><topic>Hepatitis</topic><topic>Hepatitis C</topic><topic>Hepatitis C, Chronic - diagnosis</topic><topic>Hepatitis C, Chronic - drug therapy</topic><topic>Hepatitis C, Chronic - epidemiology</topic><topic>Hepatocellular carcinoma</topic><topic>Hepatology</topic><topic>HIV</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - epidemiology</topic><topic>HIV Infections - pathology</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Liver cancer</topic><topic>Liver cirrhosis</topic><topic>Liver Cirrhosis - epidemiology</topic><topic>Liver Cirrhosis - pathology</topic><topic>Liver Cirrhosis - virology</topic><topic>Liver diseases</topic><topic>Liver Neoplasms - epidemiology</topic><topic>Liver Neoplasms - pathology</topic><topic>Liver Neoplasms - virology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate Analysis</topic><topic>Prevalence</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk factors</topic><topic>Survival Analysis</topic><topic>Viral Load</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Salmon‐Ceron, Dominique</creatorcontrib><creatorcontrib>Nahon, Pierre</creatorcontrib><creatorcontrib>Layese, Richard</creatorcontrib><creatorcontrib>Bourcier, Valérie</creatorcontrib><creatorcontrib>Sogni, Philippe</creatorcontrib><creatorcontrib>Bani‐Sadr, Firouze</creatorcontrib><creatorcontrib>Audureau, Etienne</creatorcontrib><creatorcontrib>Merchadou, Laurence</creatorcontrib><creatorcontrib>Dabis, François</creatorcontrib><creatorcontrib>Wittkop, Linda</creatorcontrib><creatorcontrib>Roudot‐Thoraval, Françoise</creatorcontrib><creatorcontrib>ANRS CO12 CirVir and ANRS CO13 HEPAVIH study groups</creatorcontrib><creatorcontrib>for the ANRS CO12 CirVir and ANRS CO13 HEPAVIH study groups</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Hepatology (Baltimore, Md.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Salmon‐Ceron, Dominique</au><au>Nahon, Pierre</au><au>Layese, Richard</au><au>Bourcier, Valérie</au><au>Sogni, Philippe</au><au>Bani‐Sadr, Firouze</au><au>Audureau, Etienne</au><au>Merchadou, Laurence</au><au>Dabis, François</au><au>Wittkop, Linda</au><au>Roudot‐Thoraval, Françoise</au><aucorp>ANRS CO12 CirVir and ANRS CO13 HEPAVIH study groups</aucorp><aucorp>for the ANRS CO12 CirVir and ANRS CO13 HEPAVIH study groups</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Human Immunodeficiency Virus/Hepatitis C Virus (HCV) Co‐infected Patients With Cirrhosis Are No Longer at Higher Risk for Hepatocellular Carcinoma or End‐Stage Liver Disease as Compared to HCV Mono‐infected Patients</atitle><jtitle>Hepatology (Baltimore, Md.)</jtitle><addtitle>Hepatology</addtitle><date>2019-09</date><risdate>2019</risdate><volume>70</volume><issue>3</issue><spage>939</spage><epage>954</epage><pages>939-954</pages><issn>0270-9139</issn><eissn>1527-3350</eissn><abstract>It is widely accepted that human immunodeficiency virus (HIV) infection is a risk factor for increased severity of hepatitis C virus (HCV) liver disease. However, owing to better efficacy and safety of combination antiretroviral therapy (cART), and increased access to HCV therapy, whether this condition remains true is still unknown. Overall, 1,253 HCV mono‐infected patients and 175 HIV/HCV co‐infected patients with cirrhosis, included in two prospective French national cohorts (ANRS CO12 CirVir and CO13 HEPAVIH), were studied. Cirrhosis was compensated (Child‐Pugh A), without past history of complication, and assessed on liver biopsy. Incidences of liver decompensation (LD), hepatocellular carcinoma (HCC), and death according to HIV status were calculated by a Fine‐Gray model adjusted for age. Propensity score matching was also performed to minimize confounding by baseline characteristics. At baseline, HIV/HCV patients were younger (47.5 vs. 56.0 years; P < 0.001), more frequently males (77.1% vs. 62.3%; P < 0.001), and had at baseline and at end of follow‐up similar rates of HCV eradication than HCV mono‐infected patients. A total of 80.4% of HIV/HCV patients had an undetectable HIV viral load. After adjustment for age, 5‐year cumulative incidences of HCC and decompensation were similar in HIV/HCV and HCV patients (8.5% vs. 13.2%, P = 0.12 and 12.8% vs. 15.6%, P = 0.40, respectively). Overall mortality adjusted for age was higher in HIV/HCV co‐infected patients (subhazard ratio [SHR] = 1.88; 95% confidence interval [CI], 1.15‐3.06; P = 0.011). Factors associated with LD and HCC were age, absence of sustained virological response, and severity of cirrhosis, but not HIV status. Using a propensity score matching 95 patients of each group according to baseline features, similar results were observed. Conclusion: In HCV‐infected patients with cirrhosis, HIV co‐infection was no longer associated with higher risks of HCC and hepatic decompensation. Increased mortality, however, persisted, attributed to extrahepatic conditions.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>30569448</pmid><doi>10.1002/hep.30400</doi><tpages>16</tpages></addata></record> |
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| identifier | ISSN: 0270-9139 |
| ispartof | Hepatology (Baltimore, Md.), 2019-09, Vol.70 (3), p.939-954 |
| issn | 0270-9139 1527-3350 |
| language | eng |
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| source | MEDLINE; Wiley Online Library Journals; EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Age Anti-Retroviral Agents - therapeutic use Antiretroviral therapy Biopsy Carcinoma, Hepatocellular - epidemiology Carcinoma, Hepatocellular - pathology Carcinoma, Hepatocellular - virology Cirrhosis Cohort Studies Coinfection - epidemiology Coinfection - pathology Coinfection - virology Disease Progression End Stage Liver Disease - epidemiology End Stage Liver Disease - pathology End Stage Liver Disease - virology Eradication Female France Hepacivirus - pathogenicity Hepatitis Hepatitis C Hepatitis C, Chronic - diagnosis Hepatitis C, Chronic - drug therapy Hepatitis C, Chronic - epidemiology Hepatocellular carcinoma Hepatology HIV HIV Infections - drug therapy HIV Infections - epidemiology HIV Infections - pathology Human immunodeficiency virus Humans Kaplan-Meier Estimate Liver cancer Liver cirrhosis Liver Cirrhosis - epidemiology Liver Cirrhosis - pathology Liver Cirrhosis - virology Liver diseases Liver Neoplasms - epidemiology Liver Neoplasms - pathology Liver Neoplasms - virology Male Middle Aged Mortality Multivariate Analysis Prevalence Prognosis Proportional Hazards Models Retrospective Studies Risk Assessment Risk factors Survival Analysis Viral Load |
| title | Human Immunodeficiency Virus/Hepatitis C Virus (HCV) Co‐infected Patients With Cirrhosis Are No Longer at Higher Risk for Hepatocellular Carcinoma or End‐Stage Liver Disease as Compared to HCV Mono‐infected Patients |
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