Hepatic Markers and Immunological Trajectories in a Cohort of Patients With HIV and Hepatitis C Virus Coinfection Treated With Direct-Acting Antivirals.

Details

• Alternative Title:
  AIDS Research and Human Retroviruses, 2025, v. 41, no. 8: Hepatic Markers and Immunological Trajectories in a Cohort of Patients With HIV and Hepatitis C Virus Coinfection Treated With Direct-Acting Antivirals.
• Journal Article:
  AIDS Research and Human Retroviruses
• Personal Author:
  Simoncini, Gina ; Li, Jun ; Mayer, Cynthia ; Collins, Lauren F. ; Battalora, Linda ; Buchacz, Kate
• Description:
  Persons with HIV (PWH) have disproportionate hepatitis C virus (HCV) infection prevalence and liver-related morbidity and mortality. These sequelae may be alleviated by curative direct-acting antiviral (DAA) treatment; however, longitudinal effects of DAAs on clinical biomarkers are not well-characterized. We included PWH enrolled in the HIV Outpatient Study (HOPS) who were prescribed DAAs and DAA-naïve PWH of comparable age, sex, race/ethnicity, and fibrosis-4 (FIB-4) profiles. We contrasted the DAA effect on longitudinal trajectories of immunological and hepatic markers using generalized linear mixed models (GLMM) from 2010 to 2020. Of 347 PWH/HCV coinfection, median age was 53.8 years, 30.5% were women, 67.1% were publicly insured, 44.4% were non-Hispanic Black, and 153 (44.1%) were prescribed DAAs (median follow-up = 3.55 years). In multivariable GLMM analysis, DAA treatment was associated with mean (95% confidence interval) faster decline in alanine aminotransferase of -7.86 mu/µL/year (-15.39, -0.33) and faster increase in platelets of 6.99 mu/µL/year (2.89, 11.09). Changes in aspartate aminotransferase were comparable between groups. FIB-4 decreased in the DAA-treated but not the DAA-naïve group: -0.26 (-0.41, -0.11) versus 0.02 (-0.16, 0.20)/year, respectively. There was a faster increase in cluster of differentiation (CD)4 count of 0.05 (0.03-0.08) and CD8 count of 0.04 (0.02-0.07) log cells/mL/year in the DAA-treated compared with the DAA-naïve group (
  
  < .001), but not in the CD4/CD8 ratio (
  
  = .36). Among U.S. PWH/HCV coinfection treated with DAAs, we found modest changes in immunological markers and substantial improvements in hepatic markers modeled over 4 years of DAA treatment. Curative DAA treatment is critical to mitigate advanced liver fibrosis.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • Female
  • Male
  • HIV Infections
  • Middle Aged
  • Coinfection
  • Antiviral Agents
  • Biomarkers
  • Adult
  • Hepatitis C, Chronic
  More +
• Keywords:
  • DAA
  • direct-acting antiviral
  • HIV
  • HCV
  • hepatitis C treatment
• Source:
  AIDS Research and Human Retroviruses, 2025, v. 41, no. 8
• DOI:
  https://doi.org/10.1089/aid.2025.0001
• ISSN:
  0889-2229 ; 1931-8405
• Pubmed ID:
  40397618
• Pubmed Central ID:
  PMC12371430
• Document Type:
  Text
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Genre:
  Journal Article
• Pages in Document:
  400-410 (20 pdf pages)
• Volume:
  41
• Issue:
  8
• Download URL:
  https://stacks.cdc.gov/view/cdc/261401/cdc_261401_DS1.pdf
• File Type:
  [PDF - 613.54 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:029dfa0da9ad1659c64099f80c4371582cc3e28ce8892ce1db652f288d36d5e27bd8661b20898039d80d6065d851fc1117ffadf57c79d54931a4d744f1fa1aa4