Progression of liver stiffness predicts clinical events in HIV/HCV-coinfected patients with compensated cirrhosis

BMC Infect Dis. 2015 Dec 7;15:557. doi: 10.1186/s12879-015-1291-3.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Carcinoma, Hepatocellular / etiology
  • Carcinoma, Hepatocellular / virology
  • Coinfection / complications
  • Female
  • Follow-Up Studies
  • HIV Infections / complications*
  • HIV Infections / pathology
  • Hepatitis C / complications*
  • Hepatitis C / pathology
  • Humans
  • Liver / pathology*
  • Liver / virology
  • Liver Cirrhosis / etiology*
  • Liver Cirrhosis / mortality
  • Liver Cirrhosis / pathology
  • Liver Cirrhosis / virology
  • Liver Neoplasms / etiology
  • Liver Neoplasms / virology
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • Survival Analysis