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DAAs therapy associated with improved hepatic fibrosis in HCV-GT4 patients co-infected with HIV

Hassan El-Garem1, Mohamed AbdAllah2, Heba Omar1

  • 1a Endemic Medicine and Hepatology Department, Faculty of Medicine , Cairo University , Giza , Egypt.

Expert Review of Gastroenterology & Hepatology
|May 3, 2019
PubMed

Insights

Direct-acting antivirals (DAAs) rapidly reduce liver fibrosis in patients with chronic hepatitis C (HCV) and HIV coinfection. This study shows significant improvements in liver stiffness and fibrosis scores after DAA treatment.

Area of Science:

  • Hepatology
  • Virology
  • Clinical Medicine

Background:

  • Chronic hepatitis C (HCV) and HIV coinfection presents unique challenges for liver disease management.
  • Direct-acting antivirals (DAAs) have revolutionized HCV treatment, but their impact on liver fibrosis in coinfected patients requires further evaluation.

Purpose of the Study:

  • To assess dynamic changes in hepatic fibrosis markers after DAA treatment in HCV/HIV coinfected individuals.
  • To evaluate the efficacy of sofosbuvir and daclatasvir in reducing liver stiffness and serum fibrosis scores.

Main Methods:

  • A cohort of 50 HCV/HIV coinfected patients received 12 weeks of sofosbuvir plus daclatasvir.
  • Liver stiffness measurement (LSM) via transient elastography, FIB-4, and APRI scores were assessed at baseline, 12, and 24 weeks post-treatment.
  • Sustained virologic response at 24 weeks (SVR24) was determined.

Main Results:

  • 93.48% of patients achieved SVR24.
  • Significant reductions were observed in LSM (7.05 to 5.66 kPa), FIB-4 (1.24 to 0.93), and APRI (0.725 to 0.36) among responders (p < 0.001 for all).
  • Most patients (70%) were on concurrent antiretroviral therapy.

Conclusions:

  • DAA therapy for HCV in coinfected patients leads to rapid and significant regression of hepatic fibrosis.
  • FibroScan, FIB-4, and APRI are valuable tools for monitoring fibrosis regression post-treatment.
  • HCV/HIV coinfected patients benefit from effective HCV eradication with DAAs, improving liver health outcomes.

Keywords:
Hepatitis C virusco-infectiondirect acting antiviralshuman immunodeficiency virusliver fibrosis

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