title: Fibrosis Regression Explains Differences in Outcome in HIV-/HCV-Coinfected Patients with Cirrhosis After Sustained Virological Response.
abstract: OBJECTIVE
  Fibrosis regression (FR) after sustained virological response (SVR) should produce a better outcome in hepatitis C (HCV)-/HIV-coinfected patients with liver cirrhosis, but there are no specific data in this issue.
  
  
  METHODS
  We compared the incidence rate (IR) and the time to develop a liver complication and death in 133 cirrhotic patients according to SVR or/and FR.
  
  
  RESULTS
  Of 42 patients with SVR, 23 (55%) had FR, in comparison with only 14 of the 91 (15%) without SVR. During a follow-up of 6.8 years (916.8 person-years), the IR of death, liver-related death, and liver-related complications were 2.45, 0.61, and 1.22 per 100 persons/year among SVR/FR, and 7.6, 5.9, and 6.81 among non-SVR without FR (p < 0.01), respectively. SVR patients without FR had also a lower rate of liver-related complications (1.78 vs 3.25; p = 0.02), but a worse IR of death (5.36) and liver-related death (2.68) than non-SVR patients with FR (1.3, and 0.65; p < 0.01). Moreover, FR was associated with less hospital admissions and decreasing alpha-fetoprotein levels. In Cox analysis, only FR was associated with a lower risk of death (adjusted hazard ratio, HR 0.36; 95% CI 0.15-0.86), and liver-related death (HR 0.15; 95% CI 0.03-0.65), whereas both FR (HR 0.09; 95% CI 0.03-0.3, p < 0.01) and SVR (HR 0.24; 95% CI 0.07-0.87) decreased the risk of liver-related complications.
  
  
  CONCLUSIONS
  Fibrosis regression after SVR is associated with the highest reduction in death of any cause, liver-related mortality, and liver-related complications in HIV-/HCV-coinfected patients with cirrhosis.
authors.affiliation: Department of Infectious Diseases, Ramon y Cajal Hospital, Cra Colmenar km 9.1, 28034, Madrid, Spain. jcasado.hrc@gmail.com.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Casado
authors.affiliation: Department of Infectious Diseases, Ramon y Cajal Hospital, Cra Colmenar km 9.1, 28034, Madrid, Spain.
authors.forename: María Angeles
authors.initials: MA
authors.lastname: Esteban
authors.affiliation: Department of Infectious Diseases, Ramon y Cajal Hospital, Cra Colmenar km 9.1, 28034, Madrid, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Bañón
authors.affiliation: Department of Infectious Diseases, Ramon y Cajal Hospital, Cra Colmenar km 9.1, 28034, Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Moreno
authors.affiliation: Department of Infectious Diseases, Ramon y Cajal Hospital, Cra Colmenar km 9.1, 28034, Madrid, Spain.
authors.forename: María J
authors.initials: MJ
authors.lastname: Perez-Elías
authors.affiliation: Department of Microbiology, Ramon y Cajal Hospital, Madrid, Spain.
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Mateos
authors.affiliation: Department of Infectious Diseases, Ramon y Cajal Hospital, Cra Colmenar km 9.1, 28034, Madrid, Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Moreno
authors.affiliation: Department of Infectious Diseases, Ramon y Cajal Hospital, Cra Colmenar km 9.1, 28034, Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Quereda
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D002423:Cause of Death; D016009:Chi-Square Distribution; D060085:Coinfection; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D006526:Hepatitis C / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000821:virology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012074:Remission Induction; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents
keywords: Cirrhosis; Fibrosis regression; HCV; HIV; Liver-related complications; Outcome; Survival