Real-Life Early Anthropometric, Lipid and Liver Changes after Direct-Acting Antiviral Therapy in PLWHIV with HCV Co-Infection

Treatment with interferon-free direct-acting antivirals (DAA) has become the gold standard in chronic hepatitis C virus (HCV) infection. Nevertheless, little research about the metabolic impact of achieving sustained virological response (SVR) is available in HCV/HIV co-infected patients. This resea...

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Main Authors: Sergio Ferra-Murcia, Antonio Ramón Collado-Romacho, Bruno José Nievas-Soriano, Fernando Reche-Lorite, Tesifón Parrón-Carreño
Format: Article
Language:English
Published: MDPI AG 2022-05-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/11/9/2639
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author Sergio Ferra-Murcia
Antonio Ramón Collado-Romacho
Bruno José Nievas-Soriano
Fernando Reche-Lorite
Tesifón Parrón-Carreño
author_facet Sergio Ferra-Murcia
Antonio Ramón Collado-Romacho
Bruno José Nievas-Soriano
Fernando Reche-Lorite
Tesifón Parrón-Carreño
author_sort Sergio Ferra-Murcia
collection DOAJ
description Treatment with interferon-free direct-acting antivirals (DAA) has become the gold standard in chronic hepatitis C virus (HCV) infection. Nevertheless, little research about the metabolic impact of achieving sustained virological response (SVR) is available in HCV/HIV co-infected patients. This research aimed to evaluate early anthropometric, lipid and liver parameters changes after achieving SVR 12 weeks after treatment (SVR12). A real-life retrospective descriptive before-after study assessed 128 DAA treatment episodes from 2015 to 2019 in HCV/HIV co-infected patients. Anthropometric parameters (weight, body mass index), lipid profile, genotype (GT) and viral load, liver data (basics laboratory necroinflammatory parameters and transient elastography (TE)) were collected before treatment with DAA (baseline), and when SVR12 was achieved. Significant increases (<i>p</i> < 0.01) were found in the early lipid profile, measured by LDLc (84.6 ± 35.0 vs. 108.6 ± 35.1 mg/dL) and total cholesterol (161.3 ± 41.0 vs. 183.3 ± 41.6 mg/dL). Significant changes (<i>p</i> < 0.05) were found in liver parameters, measured by ALT (58.2 ± 34.0 vs. 22.0 ± 16.0 U/L), bilirubin (0.8 ± 0.6 vs. 0.6 ± 0.5 mg/dL), albumin (4.2 ± 0.4 vs. 4.3 ± 0.3 g/dL) and liver stiffness (LS) (13.7 ± 13.3 vs. 11.8 ± 12.1 kPa). The main conclusions were that the use of DAA has an early negative impact on lipid metabolism. Achieving SVR12 against HCV leads to an early improvement in liver function and LS in HCV/HIV co-infected patients without interference with antiretroviral treatment (ART) and DAA. Short-term close lipid monitoring may be necessary when combining protease inhibitors. HCV-GT-3/HIV co-infected patients might require further close monitoring for residual fibrosis. These findings can be relevant for actual clinical practice.
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spelling doaj.art-71781a05bc924eeca3197a3f8c7c6cbb2023-11-23T08:35:19ZengMDPI AGJournal of Clinical Medicine2077-03832022-05-01119263910.3390/jcm11092639Real-Life Early Anthropometric, Lipid and Liver Changes after Direct-Acting Antiviral Therapy in PLWHIV with HCV Co-InfectionSergio Ferra-Murcia0Antonio Ramón Collado-Romacho1Bruno José Nievas-Soriano2Fernando Reche-Lorite3Tesifón Parrón-Carreño4Infectious Diseases Unit, Internal Medicine Service, Torrecárdenas University Hospital, 04009 Almeria, SpainInfectious Diseases Unit, Internal Medicine Service, Torrecárdenas University Hospital, 04009 Almeria, SpainDepartment of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, SpainDepartment of Mathematics-Statistics and Operations Research Area, University of Almeria, 04120 Almeria, SpainDepartment of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, SpainTreatment with interferon-free direct-acting antivirals (DAA) has become the gold standard in chronic hepatitis C virus (HCV) infection. Nevertheless, little research about the metabolic impact of achieving sustained virological response (SVR) is available in HCV/HIV co-infected patients. This research aimed to evaluate early anthropometric, lipid and liver parameters changes after achieving SVR 12 weeks after treatment (SVR12). A real-life retrospective descriptive before-after study assessed 128 DAA treatment episodes from 2015 to 2019 in HCV/HIV co-infected patients. Anthropometric parameters (weight, body mass index), lipid profile, genotype (GT) and viral load, liver data (basics laboratory necroinflammatory parameters and transient elastography (TE)) were collected before treatment with DAA (baseline), and when SVR12 was achieved. Significant increases (<i>p</i> < 0.01) were found in the early lipid profile, measured by LDLc (84.6 ± 35.0 vs. 108.6 ± 35.1 mg/dL) and total cholesterol (161.3 ± 41.0 vs. 183.3 ± 41.6 mg/dL). Significant changes (<i>p</i> < 0.05) were found in liver parameters, measured by ALT (58.2 ± 34.0 vs. 22.0 ± 16.0 U/L), bilirubin (0.8 ± 0.6 vs. 0.6 ± 0.5 mg/dL), albumin (4.2 ± 0.4 vs. 4.3 ± 0.3 g/dL) and liver stiffness (LS) (13.7 ± 13.3 vs. 11.8 ± 12.1 kPa). The main conclusions were that the use of DAA has an early negative impact on lipid metabolism. Achieving SVR12 against HCV leads to an early improvement in liver function and LS in HCV/HIV co-infected patients without interference with antiretroviral treatment (ART) and DAA. Short-term close lipid monitoring may be necessary when combining protease inhibitors. HCV-GT-3/HIV co-infected patients might require further close monitoring for residual fibrosis. These findings can be relevant for actual clinical practice.https://www.mdpi.com/2077-0383/11/9/2639HCV/HIV co-infecteddirect-acting antiviralsmetabolic impactcomorbidity PLWHIVbefore-after DAA therapy
spellingShingle Sergio Ferra-Murcia
Antonio Ramón Collado-Romacho
Bruno José Nievas-Soriano
Fernando Reche-Lorite
Tesifón Parrón-Carreño
Real-Life Early Anthropometric, Lipid and Liver Changes after Direct-Acting Antiviral Therapy in PLWHIV with HCV Co-Infection
Journal of Clinical Medicine
HCV/HIV co-infected
direct-acting antivirals
metabolic impact
comorbidity PLWHIV
before-after DAA therapy
title Real-Life Early Anthropometric, Lipid and Liver Changes after Direct-Acting Antiviral Therapy in PLWHIV with HCV Co-Infection
title_full Real-Life Early Anthropometric, Lipid and Liver Changes after Direct-Acting Antiviral Therapy in PLWHIV with HCV Co-Infection
title_fullStr Real-Life Early Anthropometric, Lipid and Liver Changes after Direct-Acting Antiviral Therapy in PLWHIV with HCV Co-Infection
title_full_unstemmed Real-Life Early Anthropometric, Lipid and Liver Changes after Direct-Acting Antiviral Therapy in PLWHIV with HCV Co-Infection
title_short Real-Life Early Anthropometric, Lipid and Liver Changes after Direct-Acting Antiviral Therapy in PLWHIV with HCV Co-Infection
title_sort real life early anthropometric lipid and liver changes after direct acting antiviral therapy in plwhiv with hcv co infection
topic HCV/HIV co-infected
direct-acting antivirals
metabolic impact
comorbidity PLWHIV
before-after DAA therapy
url https://www.mdpi.com/2077-0383/11/9/2639
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