- Liver stiffness (LS) at time of sustained virologic response (SVR) identifies risk of subsequent hepatic complications (hepatocellular carcinoma [HCC]), mortality in HIV/HCV-coinfected patients with advanced fibrosis receiving direct-acting antivirals (DAAs).
Why this matters
- Consider LS to identify patients at SVR at lower risk for liver complications, for removal from HCC surveillance.
- 640 patients.
- 2.8% (18), 0.3% (2) patients developed hepatic complications, underwent liver transplant, respectively; 3.0% (19) reached primary endpoint after median follow-up of 10.2 (range, 5.6-16.8) months.
- Multivariate, predictors of liver complications, transplant:
- Pretreatment Model for End-Stage Liver Disease scores >10 (subhazard ratio [SHR], 1.37; P=.031).
- Child-Pugh-Turcotte (CPT) score B or C (SHR, 62.5; P=.007).
- Prior liver decompensation (SHR, 3.42; P=.014).
- CPT at SVR (SHR, 10.71; P=.027).
- CD4 cell count
- Fibrosis-4 score index at SVR (SHR, 1.39; P=.002), LS at SVR (SHR, 1.05; P=.002).
- No patient with LS
- Prospective analysis of predictive ability of VCTE-measured LS at time of SVR for liver complications in HIV/HCV-coinfected Spanish patients with advanced liver fibrosis or cirrhosis.
- Funding: Instituto de Salud Carlos III.
- Limited generalizability.
- Insufficient follow-up duration.