title: Progression of liver stiffness predicts clinical events in HIV/HCV-coinfected patients with compensated cirrhosis.
abstract: BACKGROUND
  Our objective was to assess the predictive value of the changes of liver stiffness (LS) for clinical outcome in HIV/HCV-coinfected patients with compensated liver cirrhosis and a LS value < 40 kPa.
  
  
  METHODS
  Prospective cohort of 275 HIV/HCV-coinfected patients with cirrhosis, no previous liver decompensation (LD) and LS < 40 kPa. The time from diagnosis to LD and/or hepatocellular carcinoma (HCC) and the predictors of this outcome were evaluated. Significant progression of LS was defined as an increase ≥ 30 % over the baseline value at any time during the follow-up.
  
  
  RESULTS
  After a median (Q1-Q3) follow-up of 32 (20-48) months, 19 (6.9 %, 95 % CI: 3.8 %-9.9 %) patients developed a first LD and/or HCC. At the end of the follow-up, 247 (90 %) patients had undergone a further LS examination. Of them, 77 (31 %) patients had a significant progression of LS. The mean (SD) survival time free of LD and/or HCC was 67 (3) and 77 (1) months in patients with or without significant progression of LS (p = 0.01). Significant progression of LS was an independent predictor of LD and/or HCC (Adjusted Hazard Ratio 4.63; 95 % confidence interval: 1.34-16.02; p = 0.015).
  
  
  CONCLUSIONS
  Significant progression of LS is associated with a higher risk of clinical events in HIV/HCV-coinfected patients with compensated cirrhosis and LS < 40 kPa.
authors.affiliation: Unidad Clínica de Enfermedades Infecciosas y Microbiología. Instituto de Biomedicina de Sevilla (IBiS). Hospital Universitario de Valme, Avenida de Bellavista s/n, 41014, Sevilla, Spain. nicolasmerchante@hotmail.com.
authors.forename: Nicolás
authors.initials: N
authors.lastname: Merchante
authors.affiliation: Unidad de Gestión Clínica de Enfermedades Infecciosas y Microbiología. Hospital de La Línea de la Concepción, AGS Campo de Gibraltar, Cádiz, Spain. francisco.tellez.perez@gmail.com.
authors.forename: Francisco
authors.initials: F
authors.lastname: Téllez
authors.affiliation: Unidad de Enfermedades Infecciosas. Hospital Universitario Reina Sofía. Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain. arjvet@gmail.com.
authors.forename: Antonio
authors.initials: A
authors.lastname: Rivero-Juárez
authors.affiliation: Unidad de Enfermedades Infecciosas. Hospital Universitario Virgen Macarena, Sevilla, Spain. mjriosvillegas@gmail.com.
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Ríos-Villegas
authors.affiliation: Unidad de Gestión Clínica de Enfermedades Infecciosas. Complejo Hospitalario de Huelva, Huelva, Spain. merinolola080@gmail.com.
authors.forename: Dolores
authors.initials: D
authors.lastname: Merino
authors.affiliation: Unidad de Gestión Clínica de Enfermedades Infecciosas. Hospital Virgen de la Victoria. Complejo Hospitalario de Málaga, Málaga, Spain. med000856@gmail.com.
authors.forename: Manuel
authors.initials: M
authors.lastname: Márquez-Solero
authors.affiliation: Unidad de Enfermedades Infecciosas. Complejo Hospitalario de Jaén, Jaén, Spain. omarampa@gmail.com.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Omar
authors.affiliation: Unidad Clínica de Enfermedades Infecciosas y Microbiología. Instituto de Biomedicina de Sevilla (IBiS). Hospital Universitario de Valme, Avenida de Bellavista s/n, 41014, Sevilla, Spain. evarecio77@gmail.com.
authors.forename: Eva
authors.initials: E
authors.lastname: Recio
authors.affiliation: Unidad de Gestión Clínica de Enfermedades Infecciosas y Microbiología. Hospital de La Línea de la Concepción, AGS Campo de Gibraltar, Cádiz, Spain. montper56@yahoo.es.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Pérez-Pérez
authors.affiliation: Unidad de Enfermedades Infecciosas. Hospital Universitario Reina Sofía. Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain. acamachoespejo@gmail.com.
authors.forename: Ángela
authors.initials: Á
authors.lastname: Camacho
authors.affiliation: Unidad de Enfermedades Infecciosas. Hospital Universitario Virgen Macarena, Sevilla, Spain. macias.sara@gmail.com.
authors.forename: Sara
authors.initials: S
authors.lastname: Macías-Dorado
authors.affiliation: Unidad Clínica de Enfermedades Infecciosas y Microbiología. Instituto de Biomedicina de Sevilla (IBiS). Hospital Universitario de Valme, Avenida de Bellavista s/n, 41014, Sevilla, Spain. juan.macias.sanchez@gmail.com.
authors.forename: Juan
authors.initials: J
authors.lastname: Macías
authors.affiliation: Unidad de Gestión Clínica de Enfermedades Infecciosas y Microbiología. Hospital de La Línea de la Concepción, AGS Campo de Gibraltar, Cádiz, Spain. slmoncada@gmail.com.
authors.forename: Sandra
authors.initials: S
authors.lastname: Lorenzo-Moncada
authors.affiliation: Unidad de Enfermedades Infecciosas. Hospital Universitario Reina Sofía. Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain. ariveror@gmail.com.
authors.forename: Antonio
authors.initials: A
authors.lastname: Rivero
authors.affiliation: Unidad Clínica de Enfermedades Infecciosas y Microbiología. Instituto de Biomedicina de Sevilla (IBiS). Hospital Universitario de Valme, Avenida de Bellavista s/n, 41014, Sevilla, Spain. japineda@telefonica.net.
authors.forename: Juan A
authors.initials: JA
authors.lastname: Pineda
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000821:virology; D060085:Coinfection / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications* / Q000473:pathology; D006526:Hepatitis C / Q000150:complications* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology* / Q000821:virology; D008103:Liver Cirrhosis / Q000209:etiology* / Q000401:mortality / Q000473:pathology / Q000821:virology; D008113:Liver Neoplasms / Q000209:etiology / Q000821:virology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016019:Survival Analysis