“Liver fibrosis progresses fast among HIV/HCV-coinfected patients and, as a consequence, after the first decompensation patients die soon,” the researchers wrote in Clinical Infectious Diseases.
“This grim prognosis can be altered by therapy against HCV. Individuals with HIV infection and compensated HCV-related cirrhosis achieving sustained virological response to therapy against HCV are at a reduced risk of liver events.”
The retrospective cohort study included 892 patients with HIV/HCV coinfection who were treated from November 1990 to June 2012. They had not previously received HCV therapy or had received treatment but not reached sustained virological response. All patients had advanced fibrosis diagnosed by liver biopsy or liver stiffness measurement. The researchers evaluated the number of liver decompensations recorded during the follow-up period.
Among the 317 patients who had liver biopsy, 40 patients experienced liver decompensation, with a rate of 2.3 decompensations per 100 person-years. At 5 years, the probability of remaining free of liver decompensation was 90%. Twelve patients with fibrosis stage 3 at baseline developed liver decompensation, for an incidence of 1.4 per 100 person-years. Twenty-eight patients with cirrhosis at baseline developed liver decompensation, for an incidence of 3.1 per 100 person-years.
