title: Sustained virological response following HCV therapy is associated with non-progression of liver fibrosis in HCV/HIV-coinfected patients.
abstract: BACKGROUND
  Chronic hepatitis C leads to progressive liver fibrosis, which is accelerated in HIV-coinfected patients. Unfortunately, hepatitis C virus (HCV) therapy provides sustained virological response (SVR) to only 40% of coinfected patients. Little is known about the regression of hepatic fibrosis in treated patients.
  
  
  METHODS
  All coinfected patients who had completed a full course of HCV therapy at our institution were identified. Liver fibrosis staging was estimated using non-invasive procedures at the time of initiating HCV therapy and reassessed at the last patient's follow-up using elastometry (FibroScan).
  
  
  RESULTS
  A total of 103 coinfected patients were identified. HCV genotype distribution was 1 (63%), 3 (29%) and 4 (8%). SVR had been attained by 34 individuals, while the remaining 69 were non-responders and/or relapsers. The mean lag time between the end of HCV therapy and the current assessment of liver fibrosis was 40 months, without differences between groups. Metavir score estimates were comparable before initiating HCV therapy in SVR and non-SVR patients. By contrast, current Metavir scores were lower in SVR than in non-SVR patients; for instance, F3-F4 estimates were 12% versus 54%, respectively (P < 0.001). Moreover, the longer the time elapsed after HCV therapy, the lower the liver fibrosis in SVR patients (rho = -0.39; P = 0.02). Conversely, liver fibrosis staging directly correlated with the lag following HCV therapy in non-SVR patients (rho = 0.25; P = 0.03).
  
  
  CONCLUSIONS
  SVR after HCV therapy is associated with non-progression of liver fibrosis in HCV/HIV-coinfected patients, although this benefit may not be universal and improvement only been recognizable after several years of follow-up.
authors.affiliation: Department of Infectious Diseases, Hospital Carlos III, Madrid, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Barreiro
authors.forename: Pablo
authors.initials: P
authors.lastname: Labarga
authors.forename: Luz
authors.initials: L
authors.lastname: Martín-Carbonero
authors.forename: Aranzazu
authors.initials: A
authors.lastname: Amor
authors.forename: Andrés
authors.initials: A
authors.lastname: Ruiz-Sancho
authors.forename: Carol
authors.initials: C
authors.lastname: Castellares
authors.forename: Juan
authors.initials: J
authors.lastname: González-Lahoz
authors.forename: Vincent
authors.initials: V
authors.lastname: Soriano
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D003627:Data Interpretation, Statistical; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000150:complications*; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013045:Species Specificity; D013997:Time Factors; D017211:Treatment Failure; D014505:Urban Population
chemical_list: D000998:Antiviral Agents