Interferon-free regimens improve portal hypertension and histological necroinflammation in HIV/HCV patients with advanced liver disease

2017 Alimentary Pharmacology & Therapeutics 45;1 (139-149)

BACKGROUND: HIV/HCV co-infected patients show accelerated fibrosis progression and higher risk for complications of portal hypertension (PHT). AIM: To assess the effects of interferon-free therapy on portal pressure, liver histology and plasma biomarkers in HIV/HCV-coinfected patients with PHT. METHODS: Twenty-two patients with paired hepatic venous pressure gradient (HVPG) measurements prior and after successful treatment (SVR) with interferon-free regimens were included. Liver stiffness was assessed by transient elastography and biopsies were scored according to METAVIR. Plasma biomarkers were determined by ELISA. RESULTS: Overall, HVPG decreased from 10.7 +/- 4.1 mmHg at baseline to 7.4 +/- 4.2 mmHg after HCV treatment (Delta:-3.3 +/- 2.7 mmHg; p /=10 mmHg, n = 11), HVPG decreased from 14.1 +/- 2.9 to 10.4 +/- 3.9 mmHg (Delta:-3.7 +/- 3.3 mmHg; p = 0.004) and a haemodynamic response (HVPG decrease >/=10%) was observed in 73%. In 64% of patients with subclinical PHT (HVPG 6-9 mmHg, n = 11), portal pressure normalised at SVR. Mean liver stiffness decreased from 20.8 kPa to 11.5 kPa (Delta:-8.8 +/- 7.4 kPa; p

Pubmed : 27910154