The following is a summary of “Longitudinal Assessment of the Enhanced Liver Fibrosis Score in the Era of Contemporary HIV and Hepatitis C Virus Treatment ,” published in the June 2023 issue of Infectious Diseases by Gardner, et al.

For a study, researchers sought to understand the trajectory of liver fibrosis in individuals with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) coinfection in the era of contemporary HIV and HCV therapy. They assessed three biomarkers of liver fibrosis: Enhanced Liver Fibrosis (ELF) score, aspartate transaminase-to-platelet ratio index (APRI), and Fibrosis-4 (FIB-4) in 116 women over 4 years.

The analysis included different periods relative to HCV treatment: 1-2 years before starting HCV treatment, within one year before (peri-HCV treatment), within one year after treatment, and 1-2 years post-treatment. They used random-effects linear regression models to examine the rate of fibrosis change during these periods, both in unadjusted models and models adjusted for factors that could influence fibrosis, such as age, race, and changes in alcohol consumption, use of integrase strand inhibitor (INSTI), waist circumference, and CD4 count.

The results showed that using INSTI nearly doubled from the pre-HCV treatment period to the peri-HCV treatment period. In the unadjusted analysis, there was a 3.3% rate of rise in ELF score before HCV treatment, followed by a decline of 2.2% during the peri-HCV treatment period and a further decline of 3.6% during the 1-year post-treatment period. However, there was a slight rise of 0.3% in ELF scores during the 1-2 years post-treatment period. Similar findings were observed for APRI and FIB-4. After adjusting for relevant factors, there was little effect on the estimated fibrosis trajectories. The study’s findings suggested a lack of significant decline in biomarkers of liver fibrosis beyond one year after HCV cure in individuals with HIV. It implied that ongoing monitoring of liver fibrosis and interventions to prevent fibrosis progression in people with HIV after the HCV cure was still crucial.

It’s important to note that the study focused specifically on women with HIV/HCV coinfection, so the findings may not be directly generalizable to other populations. Further research was needed to understand better the long-term effects of HCV cure on liver fibrosis in individuals with HIV and HCV coinfection.

Source: academic.oup.com/jid/article-abstract/227/11/1274/6650396?redirectedFrom=fulltext