Abstract
Background: Data on liver fibrosis evolution in HIV-HBV-coinfected patients treated with tenofovir disoproxil fumarate (TDF) are scarce. The effect of TDF on liver fibrosis in 148 HIV-HBV-coinfected patients was prospectively evaluated using Fibrometer® scores and liver biopsies in a subset of patients. Methods: The mean change from baseline (Δ) in Fibrometer score was modelled using a generalized estimating equation. Homogeneous continuous-time Markov models were used to study risk factors for regression or progression of liver fibrosis. Results: Median follow-up of patients treated with TDF was 29.5 months (25th-75th percentile 20.9-38.1). The distribution of scored fibrosis at TDF initiation was F0-F1 n=65, F2 n=37 and F3-F4 n=46. In patients with a baseline fibrosis score of F3-F4, Fibrometer score decreased with a triphasic shape (Fibrometer Δ at 12, 24 and 36 months after TDF initiation was -0.079, -0.069 and -0.102, respectively). Despite duration on TDF, higher fibrosis scores were noted in F3-F4 patients with high HBV viral load and HDV coinfection, and in F0-F2 patients who had high HBV viral load and low CD4 + T-cell count. Progression in fibrosis score over time was influenced by age, alcohol consumption, low CD4+ T-cell count and HCV coinfection, whereas HDV coinfection and longer duration of HBV infection prevented fibrosis regression. No influence of antiretrovirals other than TDF was found. Conclusions: The use of TDF in HIV-HBV-coinfected patients led to a decrease in liver fibrosis score in patients with advanced fibrosis or cirrhosis. Sustainability of its direct antiviral and indirect antifibrotic effects on the liver need to be studied further. ©2010 International Medical Press.
Original language | English |
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Pages (from-to) | 963-974 |
Number of pages | 12 |
Journal | Antiviral therapy |
Volume | 15 |
Issue number | 7 |
DOIs | |
Publication status | Published - 2010 |
Externally published | Yes |
Keywords
- Adenine/analogs & derivatives
- Adult
- Anti-HIV Agents/metabolism
- Antiretroviral Therapy, Highly Active
- CD4 Lymphocyte Count
- Cohort Studies
- DNA, Viral/drug effects
- Female
- HIV Infections/complications
- Hepacivirus/drug effects
- Hepatitis B virus/drug effects
- Hepatitis B, Chronic/complications
- Hepatitis C/complications
- Hepatitis D, Chronic/complications
- Humans
- Liver Cirrhosis/drug therapy
- Male
- Middle Aged
- Organophosphonates/metabolism
- Tenofovir
- Viral Load