Reversal of fibrosis following successful HCV therapy among HIV/HCV co-infected people who use drugs (PWID)

Author: Truong D, Bhutani Y, Kiani G, Singh A, Nitelescu R, Wong L, Alimohammadi A, Klein M, Conway B

Theme: Clinical Research Year: 2017

Recent data suggest significant reversal of fibrosis following successful HCV therapy may occur among a wide range of populations. These data have not been widely evaluated among PWUD, especially those who are co-infected with HIV.

The Canadian HIV/HCV co-infection cohort is an ongoing national observational study. All subjects are seen every 6 months. Demographic, behavioral and clinical data are collected, including ongoing information about recreational drug use, HCV disease staging, and HCV treatment status. Within this cohort, we have identified individuals determined to be PWUD (defined as confirmed drug use at least 6 months before treatment start) who have been successfully treated for their HCV infection and in whom evaluation of liver fibrosis (evaluated by FibroScan) has been completed before and after HCV treatment. This analysis was conducted to document changes in fibrosis stage over time, and the correlates of such changes.

A total of 94 eligible subjects were identified (72 male, 83 Caucasian, 9 Indigenous, mean age 48 years, 70 genotype 1, 14 genotype 3). Compared to pre-treatment evaluations, a median reduction in FibroScan score of 2.60 kPa is documented a median of 24 weeks post-treatment, with further improvement (median decrease of 4.03 kPa) at 48 weeks post-treatment.

Improvement in liver fibrosis appears to be significant following successful HCV therapy among HIV/HCV co-infected PWUD. This provides an additional rationale for the treatment of HCV infection in this population, particularly among individuals with more advanced stages of fibrosis at baseline.

Download abstract Download poster