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Burden of significant liver damage in people living with HIV after microelimination of the hepatitis C virus

  • M. Santos
    Affiliations
    Unidad de Enfermedades Infecciosas y Microbiología. Hospital Universitario Virgen de Valme. Sevilla, Spain

    Instituto de Biomedicina de Sevilla (IBiS), Spain

    CIBERINFEC. Spain
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  • A. Corma-Gómez
    Affiliations
    Unidad de Enfermedades Infecciosas y Microbiología. Hospital Universitario Virgen de Valme. Sevilla, Spain

    Instituto de Biomedicina de Sevilla (IBiS), Spain

    CIBERINFEC. Spain
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  • M. Fernandez-Fuertes
    Affiliations
    Unidad de Enfermedades Infecciosas y Microbiología. Hospital Universitario Virgen de Valme. Sevilla, Spain

    Instituto de Biomedicina de Sevilla (IBiS), Spain

    CIBERINFEC. Spain
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  • A. González-Serna
    Affiliations
    Unidad de Enfermedades Infecciosas y Microbiología. Hospital Universitario Virgen de Valme. Sevilla, Spain

    Instituto de Biomedicina de Sevilla (IBiS), Spain

    CIBERINFEC. Spain

    Department of Physiology, University of Sevilla. Sevilla, Spain
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  • P. Rincón
    Affiliations
    Unidad de Enfermedades Infecciosas y Microbiología. Hospital Universitario Virgen de Valme. Sevilla, Spain

    Instituto de Biomedicina de Sevilla (IBiS), Spain

    CIBERINFEC. Spain
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  • L.M. Real
    Affiliations
    Unidad de Enfermedades Infecciosas y Microbiología. Hospital Universitario Virgen de Valme. Sevilla, Spain

    Instituto de Biomedicina de Sevilla (IBiS), Spain

    CIBERINFEC. Spain

    Department of Surgical Specialties, Biochemistry and Immunology. University of Málaga, Málaga, Spain
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  • J.A. Pineda
    Correspondence
    Corresponding author at: Unit of Infectious Diseases. Hospital Universitario de Valme. Avenida de Bellavista s/n. 41014 Sevilla, Spain.
    Affiliations
    Unidad de Enfermedades Infecciosas y Microbiología. Hospital Universitario Virgen de Valme. Sevilla, Spain

    CIBERINFEC. Spain

    Department of Medicine. University of Sevilla. Sevilla, Spain
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  • J. Macías
    Affiliations
    Unidad de Enfermedades Infecciosas y Microbiología. Hospital Universitario Virgen de Valme. Sevilla, Spain

    Instituto de Biomedicina de Sevilla (IBiS), Spain

    CIBERINFEC. Spain

    Department of Medicine. University of Sevilla. Sevilla, Spain
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Published:November 18, 2022DOI:https://doi.org/10.1016/j.jinf.2022.11.004

      Highlights

      • There is a high burden of liver damage in people living with HIV in the post-HCV era.
      • Residual injury due to prior chronic HCV infection is an outstanding cause.
      • Nonviral liver disease is also very common, and 72.5% corresponds to metabolic associated steatohepatitis.

      Abstract

      Background

      Once HIV/HCV-coinfection microelimination has been virtually achieved in some countries, there is no information about the burden of liver disease among people living with HIV (PLWH). The aim of this study was to define the current prevalence and causes of significant liver damage (SLD) in PLWH.

      Methods

      Cross-sectional study including 619 PLWH. SLD was defined as liver stiffness (LS) ≥ 7.2 kPa measured by transient elastography. Nonviral liver damage (NVLD) was considered if there was no evidence injury due to chronic hepatitis C virus (HCV) infection, active hepatitis B (HBV) or E virus infections.

      Results

      One hundred and twelve of 619 (18.2%) PLWH showed SLD, including 34/112 (5.5%) with LS ≥14 kPa. 72/112 (64.3%) had cured HCV infection, 4/112 (3.6%) active HBV infection, and 2/112 HBV/prior HCV coinfection. Thus, 40 (35.7%) showed NVLD. Metabolic associated steatohepatitis (MASH) was present in 29/40 (72.5%) of patients with NVLD, alcoholic liver damage in 2/40 (2.5%) and mixed steatohepatitis in 5/40 (12.5%).

      Conclusions

      After HIV/HCV microelimination the burden of liver damage is high among PLWH. Persistent injury after HCV is a very frequent cause of SLD. However, NVLD, mainly due to MASH, is also a common condition in this population.

      Keywords

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