Liver Fibrosis Regression Measured by Transient Elastography in Human Immunodeficiency Virus (HIV)-Hepatitis B Virus (HBV)-Coinfected Individuals on Long-Term HBV-Active Combination Antiretroviral Therapy

Abstract Background. Advanced fibrosis occurs more commonly in human immunodeficiency virus (HIV)-hepatitis B virus (HBV) coinfected individuals; therefore, fibrosis monitoring is important in this population. However, transient elastography (TE) data in HIV-HBV coinfection are lacking. We aimed to assess liver fibrosis using TE in a cross-sectional study of HIV-HBV coinfected individuals receiving combination HBV-active (lamivudine and/or tenofovir/tenofovir-emtricitabine) antiretroviral therapy, identify factors associated with advanced fibrosis, and examine change in fibrosis in those with >1 TE assessment. Methods. We assessed liver fibrosis in 70 HIV-HBV coinfected individuals on HBV-active combination antiretroviral therapy (cART). Change in fibrosis over time was examined in a subset with more than 1 TE result (n = 49). Clinical and laboratory variables at the time of the first TE were collected, and associations with advanced fibrosis (≥F3, Metavir scoring system) and fibrosis regression (of least 1 stage) were examined. Results. The majority of the cohort (64%) had mild to moderate fibrosis at the time of the first TE, and we identified alanine transaminase, platelets, and detectable HIV ribonucleic acid as associated with advanced liver fibrosis. Alanine transaminase and platelets remained independently advanced in multivariate modeling. More than 28% of those with >1 TE subsequently showed liver fibrosis regression, and higher baseline HBV deoxyribonucleic acid was associated with regression. Prevalence of advanced fibrosis (≥F3) decreased 12.3% (32.7%–20.4%) over a median of 31 months. Conclusions. The observed fibrosis regression in this group supports the beneficial effects of cART on liver stiffness. It would be important to study a larger group of individuals with more advanced fibrosis to more definitively assess factors associated with liver fibrosis regression.

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Association of Hepatitis B Core-Related Antigen and Antihepatitis B Core Antibody With Liver Fibrosis Evolution in Human Immunodeficiency Virus-Hepatitis B Virus Coinfected Patients During Treatment With Tenofovir

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa215 ◽

2020 ◽

Vol 7 (7) ◽

Author(s):

Romuald Cruchet ◽

Lorenza N C Dezanet ◽

Sarah Maylin ◽

Audrey Gabassi ◽

Hayette Rougier ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Hepatitis B Virus ◽

Antiretroviral Therapy ◽

Liver Fibrosis ◽

Hepatitis B ◽

Advanced Fibrosis ◽

B Virus ◽

Immunodeficiency Virus ◽

Fibrosis Regression

Abstract Background Quantitative hepatitis B core-related antigen (qHBcrAg) or antihepatitis B core antibody (qAnti-HBc) could be useful in monitoring liver fibrosis evolution during chronic hepatitis B virus (HBV) infection, yet it has not been assessed in human immunodeficiency virus (HIV)-HBV-coinfected patients undergoing treatment with tenofovir (TDF). Methods One hundred fifty-four HIV-HBV-infected patients initiating a TDF-containing antiretroviral regimen were prospectively followed. The qHBcrAg and qAnti-HBc and liver fibrosis assessment were collected every 6–12 months during TDF. Hazard ratios (HRs) assessing the association between qHBcrAg/qAnti-HBc and transitions from none/mild/significant fibrosis to advanced fibrosis/cirrhosis (progression) and from advanced fibrosis/cirrhosis to none/mild/significant fibrosis (regression) were estimated using a time-homogeneous Markov model. Results At baseline, advanced liver fibrosis/cirrhosis was observed in 40 (26%) patients. During a median follow-up of 48 months (interquartile range, 31–90), 38 transitions of progression (IR = 7/100 person-years) and 34 transitions of regression (IR = 6/100 person-years) were observed. Baseline levels of qHBcrAg and qAnti-HBc were not associated with liver fibrosis progression (adjusted-HR per log10 U/mL = 1.07, 95% confidence interval [CI] = 0.93–1.24; adjusted-HR per log10 Paul-Ehrlich-Institute [PEI] U/mL = 0.85, 95% CI = 0.70–1.04, respectively) or regression (adjusted-HR per log10 U/mL = 1.17, 95% CI = 0.95–1.46; adjusted-HR per log10 PEI U/mL = 0.97, 95% CI = 0.78–1.22, respectively) after adjusting for age, gender, duration of antiretroviral therapy, protease inhibitor-containing antiretroviral therapy, and CD4+/CD8+ ratio. Nevertheless, changes from the previous visit of qAnti-HBc levels were associated with liver fibrosis regression (adjusted-HR per log10 PEIU/mL change = 5.46, 95% CI = 1.56–19.16). Conclusions Baseline qHBcrAg and qAnti-HBc levels are not associated with liver fibrosis evolution in TDF-treated HIV-HBV coinfected patients. The link between changes in qAnti-HBc levels during follow-up and liver fibrosis regression merits further study.

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Predictive factors associated with liver fibrosis and steatosis by transient elastography in patients with HIV mono-infection under long-term combined antiretroviral therapy

Journal of the International AIDS Society ◽

10.1002/jia2.25201 ◽

2018 ◽

Vol 21 (11) ◽

pp. e25201 ◽

Cited By ~ 19

Author(s):

Hugo Perazzo ◽

Sandra W Cardoso ◽

Carolyn Yanavich ◽

Estevão P Nunes ◽

Michelle Morata ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Liver Fibrosis ◽

Predictive Factors ◽

Transient Elastography ◽

Factors Associated ◽

Combined Antiretroviral Therapy

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Faculty Opinions recommendation of Treatment modification in human immunodeficiency virus-infected individuals starting combination antiretroviral therapy between 2005 and 2008.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.3057959.2739057 ◽

2010 ◽

Author(s):

Caroline Sabin

Keyword(s):

Human Immunodeficiency Virus ◽

Antiretroviral Therapy ◽

Combination Antiretroviral Therapy ◽

Treatment Modification ◽

Immunodeficiency Virus

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Is ventricular arrhythmias the end for all conditions ?

Medical Principles and Practice ◽

10.1159/000514379 ◽

2021 ◽

Author(s):

Ahmet Goktug Ertem ◽

Mehmet Akif Erdol ◽

Koray Demirtas ◽

Sefa Unal ◽

Mustafa Karanfil ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Risk Factor ◽

Antiretroviral Therapy ◽

Ventricular Arrhythmias ◽

Combination Antiretroviral Therapy ◽

T Wave ◽

Medical Status ◽

Immunodeficiency Virus ◽

Duration Of Disease ◽

Severity Of The Disease

Dear Editor, We read the article entitled “Abnormal Dispersion of Ventricular Repolarization as a Risk Factor in Patients with Human Immunodeficiency Virus: Tp-e Interval, Tp-e/QTc Ratio” by Unal Evren et al. with interest[1]. The authors evaluated the changes in Tp-e interval, Tp-e/QT and Tp-e/corrected QT (QTc) ratios, and traditional electrocardiographic features of electrical dispersion in adults infected with Human Immunodeficiency Virus (HIV) and their study revealed that the cTp-e interval, Tp-e/QT and Tp-e/QTc ratios were prolonged and correlated to the severity of the disease in HIV-infected patients. Previous studies have revealed that the Tp–e interval, the Tpeak-Tend interval (Tpe), the interval from the T-wave peak to the end of the T wave, has been related to arrhythmogenesis, is specified as an index of totaldispersion of repolarization[2]. Prolonged Tp–e interval is predictable for ventricular arrhythmias and mortality [3]. Unal et al. showed that HIV-infected patients receiving combination antiretroviral therapy (cART) were associated withlonger Tp–e interval and Tp–e/QTc ratio and correlated positively with the duration of disease and the electrophysiologicalabnormalities, and negatively with CD4 count[4]. There were no informations about medical status of patients with HIV, duration of the disease and why hsCRP is higher in patients’ group. The patients were in active phases of infection. We think that these are important datas for results of the study. We thank the authors for adding this article to the literature

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A Case of Hepatitis B Virus/human Immunodeficiency Virus Coinfection in a Patient Who Achived Hepatitis B Surface Antigen Seroclearance After Interferon Therapy Followed by Antiretroviral Therapy without Developing Immune Reconstitution Inflammatory Syndrome

Kansenshogaku zasshi ◽

10.11150/kansenshogakuzasshi.86.763 ◽

2012 ◽

Vol 86 (6) ◽

pp. 763-767 ◽

Cited By ~ 2

Author(s):

Fujiko MITSUMOTO ◽

Masayuki MURATA ◽

Hiroaki IKEZAKI ◽

Eiichi OGAWA ◽

Hiroaki TANIAI ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Hepatitis B Virus ◽

Antiretroviral Therapy ◽

Hepatitis B ◽

Immune Reconstitution ◽

Interferon Therapy ◽

Hepatitis B Surface Antigen ◽

B Virus ◽

Immunodeficiency Virus ◽

Inflammatory Syndrome

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Microscopic and biochemical changes on liver and kidney of Wistar rats on combination antiretroviral therapy: the impact of naringenin and quercetin

Toxicology Research ◽

10.1093/toxres/tfaa060 ◽

2020 ◽

Vol 9 (5) ◽

pp. 601-608

Author(s):

Edidiong Nnamso Akang ◽

Olufunke O Dosumu ◽

Ini-ibehe Essien Okoko ◽

Oluwatomisin Faniyan ◽

Ademola A Oremosu ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Wistar Rats ◽

Combination Antiretroviral Therapy ◽

Necrosis Factor Alpha ◽

Immunodeficiency Virus ◽

Male Wistar Rats ◽

Liver And Kidney ◽

Factor Alpha ◽

Continuous Use ◽

The Impact

Abstract Combination antiretroviral therapy (cART), which is a lifelong therapy for people living with human immunodeficiency virus, has been associated with nephrotoxicity and hepatotoxicity leading to its discontinuation. This study aimed at investigating the ameliorative potential of naringenin and quercetin on cART-induced hepatotoxicity and nephrotoxicity. Seventy male Wistar rats (225–260 g) were divided into seven groups as control, cART, naringenin, quercetin, dimethyl sulfoxide (DMSO), naringenin/cART (CN) and quercetin/cART (CQ). cART (24 mg/kg), naringenin (50 mg/kg) and quercetin (50 mg/kg) were dissolved in 1% v/v DMSO and administered orally for 56 days. Combination of cART and bioflavonoids had significant increase in superoxide dismutase (P < 0.05), catalase (P < 0.01), reduced glutathione (P < 0.001) and decreased malondialdehyde (P < 0.001) compared to cART only. Tumor necrosis factor Alpha (TNFα) level increased significantly in cART and CQ (P < 0.01) groups, while others showed no significant changes compared to control. TNFα also significantly decreased in CQ level compared to cART (P < 0.001). In addition, significant increase in creatinine level in cART only indicated progressive renal toxicity. Also, progressive pathological changes including congested blood vessels and hepatocellular necrosis were found in the liver, while the kidney had glomerular atrophy, and tubular distortion in cART-only group. Control, naringenin- and quercetin-treated groups showed normal renal and hepatic cytoarchitecture. These findings elucidate that progressive renal and hepatic toxicity is associated with the continuous use of cART; however, a combination of quercetin and naringenin with cART showed possible potential of ameliorating the damages posed by cART.

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Tu1478 – Rest-B Study: Liver Fibrosis Regression Assessed by Transient Elastography (TE) in Patients with Chronic Hepatitis B (CHB) on Long Term Maintenance Therapy with Tenofovir Disoproxil Fumarate (TDF)

Gastroenterology ◽

10.1016/s0016-5085(19)40358-2 ◽

2019 ◽

Vol 156 (6) ◽

pp. S-1336-S-1337

Author(s):

Hariklia Kranidioti ◽

KANELLOS-RAFAIL KOUSTENIS ◽

Adonis A. Protopapas ◽

Theodoros Voulgaris ◽

Chrisostomos Tsolias ◽

...

Keyword(s):

Chronic Hepatitis ◽

Liver Fibrosis ◽

Hepatitis B ◽

Maintenance Therapy ◽

Chronic Hepatitis B ◽

Tenofovir Disoproxil Fumarate ◽

Transient Elastography ◽

Fibrosis Regression ◽

Term Maintenance

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Baseline Amino Acid Substitutions in the NS5A ISDR and PKR Binding Domain of Hepatitis C and Different Fibrosis Levels and Levels of Development of Hepatocellular Carcinoma in Patients Treated with DAAs

Viruses ◽

10.3390/v12030255 ◽

2020 ◽

Vol 12 (3) ◽

pp. 255

Author(s):

Stefania Paolucci ◽

Antonio Piralla ◽

Federica Novazzi ◽

Alice Fratini ◽

Renato Maserati ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Hepatitis C ◽

Liver Fibrosis ◽

High Frequency ◽

Transient Elastography ◽

Hcv Rna ◽

Amino Acid Substitutions ◽

Advanced Fibrosis ◽

Ns5a Region ◽

Advanced Liver Fibrosis

Variations in the interferon sensitivity-determining region (ISDR) within the NS5A region were related to the development of hepatocellular carcinoma (HCC) in patients infected with hepatitis C virus (HCV). The aim of the study was to investigate a relationship between ISDR/PKR substitutions and their association with liver fibrosis or HCC development. A total of 316 patients infected with HCV and treated with DAAs were evaluated. HCV RNA was quantified and sequenced before treatment. The liver fibrosis stage was assessed by transient elastography and equalized to METAVIR scores. Multivariate analysis showed that ≥3 substitutions in ISDR and ≥6 in PKR-bd were significantly associated with advanced fibrosis. Advanced fibrosis was observed in patients with higher substitutions in ISDR and PKR-bd. A higher correlation between advanced fibrosis and a high frequency of ≥3 substitutions in ISDR and ≥6 in PKR-bd was observed in patients infected with genotype 2c. In addition, in a higher proportion of HCC patients, advanced fibrosis (40.4% vs. 88.2%; p < 0.001) and ≥6 substitutions in PKR-bd (15.4% vs. 41.2%; p = 0.01) was observed. In conclusion, a higher number of substitutions in ISDR and PKR-bd were associated with advanced liver fibrosis, suggesting a use of like predictors for progression in the liver damage. A significantly higher number of PKR-bd substitutions was observed in HCC patients; in particular, in patients infected with HCV genotype 2c.

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