Details

Autor(en) / Beteiligte

• Shili-Masmoudi, Sarah
• Sogni, Philippe
• de Ledinghen, Victor
• Esterle, Laure
• Valantin, Marc-Antoine
• Poizot-Martin, Isabelle
• Simon, Anne
• Rosenthal, Eric
• Lacombe, Karine
• Pialoux, Gilles
• Bouchaud, Olivier
• Gervais-Hasenknoff, Anne
• Goujard, Cécile
• Piroth, Lionel
• Zucman, David
• Dominguez, Stéphanie
• Raffi, François
• Alric, Laurent
• Bani-Sadr, Firouzé
• Lascoux-Combe, Caroline
• Garipuy, Daniel
• Miailhes, Patrick
• Vittecoq, Daniel
• Duvivier, Claudine
• Aumaître, Hugues
• Neau, Didier
• Morlat, Philippe
• Dabis, François
• Salmon, Dominique
• Wittkop, Linda
• Lin, Wenyu

Titel

Increased liver stiffness is associated with mortality in HIV/HCV coinfected subjects: The French nationwide ANRS CO13 HEPAVIH cohort study

Ist Teil von

• PloS one, 2019-01, Vol.14 (1), p.e0211286-e0211286

Ort / Verlag

United States: Public Library of Science

Erscheinungsjahr

2019

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• The association between liver stiffness measurements (LSM) and mortality has not been fully described. In particular the effect of LSM on all-cause mortality taking sustained virological response (SVR) into account needs further study. HIV/HCV participants in the French nation-wide, prospective, multicenter ANRS CO13 HEPAVIH cohort, with ≥1 LSM by FibroScan (FS) and a detectable HCV RNA when the first valid FS was performed were included. Cox proportional hazards models with delayed entry were performed to determine factors associated with all-cause mortality. LSM and SVR were considered as time dependent covariates. 1,062 patients were included from 2005 to 2015 (69.8% men, median age 45.7 years (IQR 42.4-49.1)). 21.7% had baseline LSM >12.5 kPa. Median follow-up was 4.9 years (IQR 3.2-6.1). 727 (68.5%) were ever treated for HCV: 189 of them (26.0%) achieved SVR. 76 deaths were observed (26 liver-related, 10 HIV-related, 29 non-liver-non-HIV-related, 11 of unknown cause). At the age of 50, the mortality rate was 4.5% for patients with LSM ≤12.5 kPa and 10.8% for patients with LSM >12.5 kPa. LSM >12.5 kPa (adjusted Hazard Ratio [aHR] = 3.35 [2.06; 5.45], p<0.0001), history of HCV treatment (aHR = 0.53 [0.32; 0.90], p = 0.01) and smoking (past (aHR = 5.69 [1.56; 20.78]) and current (3.22 [0.93; 11.09]) versus never, p = 0.01) were associated with all-cause mortality independently of SVR, age, sex, alcohol use and metabolic disorders. Any LSM >12.5 kPa was strongly associated with all-cause mortality independently of SVR and other important covariates. Our results suggest that close follow-up of these patients should remain a priority even after achieving SVR.