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Long-term liver stiffness dynamics after sustained virological response in patients with HIV/HCV co-infection and advanced fibrosis
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Download the PDF here
Download the PDF here
Role of Old ART Drugs, Nukes. HIV and Liver Disease Forum
CROI: Impact of HIV Infection on the Dynamics of Liver Stiffness After HCV Cure - (03/11/25)
AASLD: Impact of MASLD on the development of hepatocellular carcinoma after HCV cure in patients with chronic hepatitis C: A large-scale, multicenter cohort study - (11/16/25)
AASLD: HIGH BURDEN OF LIVER FIBROSIS IN 4,809 PEOPLE WITH HIV MONOINFECTION UNDERGOING SCREENING FOR STEATOTIC LIVER DISEASE - (11/16/25)
AASLD: MASLD in People Living with HIV: An Emerging Challenge - (11/16/25)
EASL: PREVALENCE OF STEATOTIC LIVER DISEASE IN PEOPLE LIVING WITH HIV AND HIGH PREVALENCE OF CARDIOVASCULAR RISK FACTORS - (05/19/25)
EASL: Identifying Risk Factors Associated with MASH for People Living with HIV - (05/09/25)
CROI: Determinants of Steatotic Liver Disease Among People with HIV in Europe and Australia - (03/20/25)
CROI: Incidence and Impact of Hepatic Steatosis in People with HIV: Insights from the NA-ACCORD Cohort - (03/17/25)
Glasgow: PREVALENCE OF METABOLIC SYNDROME IN PEOPLE LIVING WITH HIV AND ITS RELATIONSHIP WITH FATTY LIVER AND CARDIOVASCULAR RISK - (11/24/24)
AIDS feb 2026
pdfs attached
In patients with HCV/HIV co-infection and advanced liver fibrosis, LS significantly decreases after achieving SVR with DAA-based regimens in the long-term. For an important proportion of patients, this improvement leads to values of LS ≤7.2 kPa. However, almost one-third of patients experience no change or even an increase in LS. Showing a more advanced liver disease prior to HCV infection cure was associated with a lower probability of achieving LS normalization. On the other hand, the presence of severe steatotic liver disease, a higher LS value, both measured at SVR, and an older age are predictors of LS progression after SVR.
This can be explained by the link between diabetes mellitus and steatotic liver disease through interconnected mechanisms. These include insulin resistance, hyperinsulinemia, oxidative and endoplasmic reticulum stress, chronic inflammation, macrophage activation, and upregulation of RAGE/TLR4 signaling pathways [28-30].
Objective:
This study analyses liver stiffness (LS) dynamics in people with HIV (PWH) and advanced liver fibrosis who achieved sustained virological response (SVR) and assess factors associated with LS normalization or progression, after long-term follow-up.
Design:
Prospective multicenter cohort study.
Methods:
This study included individuals with HIV/HCV co-infection from the Spanish GEHEP-011 cohort, fulfilling: pretreatment LS ≥9.5 kPa; sustained virological response (SVR) with direct-acting antiviral regimen; available measurement of LS at SVR. Factors associated with LS normalization (achieving ≤7.2 kPa in two consecutive measurement) and progression (increase of >20% LS at the last measurement available) were analyzed.
Results:
A total of 678 patients were included. The median follow-up was 40 (17-71) months. The repeated measures ANOVA revealed a significant main effect of time on LS.
Overall, 221 (32.6%) achieved normalization. Lower probability of normalization was associated with advanced liver disease [baseline LS: sHR = 0.26 (95% CI, 0.19-0.37), P < 0.001; liver decompensation before SVR: sHR = 0.22 (0.05-0.97), P < 0.001; baseline MELD score: sHR = 0.81 (0.69-0.94), P = 0.006]. LS progression occurred in 50 (7.4%).
Progression was associated with higher baseline LS [sHR = 1.04 (1.01-1.07), P = 0.007], controlled attenuation parameter (CAP) [CAP ≥ 280 dB/m: sHR = 2.94 (1.16-7.44)] and older age [sHR 1.06 (1.00-1.13), per year, P = 0.04].
Conclusions:
In PWH, LS significantly decreases after HCV cure in the long-term, achieving values of ≤7.2 kPa. In a substantial proportion of patients, LS remain stable or even increases. Older age and concomitant steatotic liver disease are associated with LS progression.
patients who experience worsening LS remain at risk of developing liver-related events [9]and should be closely monitored.
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