Background: Whether continued, accelerated liver fibrosis progression occurs following acute hepatitis C virus infection (AHCVI) in HIV-positive MSM is unknown. Design and methods: HIV-positive MSM from the AIDS Therapy Evaluation in the Netherlands and MSM Observational Study for Acute Infection with Hepatitis C-cohorts with primary AHCVI and at least one fibrosis-4 (FIB-4) measurement less than 2 years before and 1 year after estimated AHCVI were included. Mixed-effect linear models were used to evaluate (time-updated) determinants of FIB-4 levels over time. Determinants of transitioning to and from FIB-4 1.45 and > 1.45 were examined using multistate Markov models. Results: Of 313 MSM, median FIB-4 measurements per individual was 12 (interquartile range ¼ 8–18) and median follow-up following AHCVI was 3.5 years (interquartile range¼ 1.9–5.6). FIB-4 measurements averaged at 1.00 [95% confidence interval (CI)¼ 0.95–1.05] before AHCVI, 1.31 (95% CI¼ 1.25–1.38) during the first year of AHCVI and 1.10(95% CI¼ 1.05–1.15)more than 1 year after AHCVI.Mean FIB-4more than 1 year after AHCVI was higher for chronically infected patients compared with those successfully treated (P¼ 0.007). Overall FIB-4 scores were significantly higher with older age, lower CD4þ cell count, longer duration from HIV-diagnosis or AHCVI, and nonresponse to HCVtreatment. At the end of follow-up, 60 (19.2%) and eight MSM (2.6%) had FIB-4 between 1.45–3.25 and 3.25, respectively. Older age, lower CD4þ cell count and detectable HIVRNA were significantly associated with higher rates of progression to FIB-4 > 1.45, whereas older age, longer duration from HIV-diagnosis and nonresponse to HCV-treatment were significantly associated with lower rates of regression to FIB-4 1.45. Conclusion: In this population of HIV-positive MSM, FIB-4 scores were higher during the first year of AHCVI, but FIB-4 3.25 was uncommon by the end of follow-up. Well controlled HIV-infection appears to attenuate FIB-4 progression.

Additional Metadata
Keywords acute hepatitis C virus infection, fibrosis-4, HIV/hepatitis C virus coinfection, liver fibrosis, MSM
Persistent URL dx.doi.org/10.1097/qad.0000000000002138, hdl.handle.net/1765/119472
Series VSNU Open Access deal
Journal AIDS
Note corresponding author at Department of Infectious Diseases Research and Prevention, Public Health Service of Amsterdam
Citation
Newsum, AM, Kooij, K.W., Boyd, A, Smit, C, de Wit, F, & van der Meer, J.T.M. (2019). Progression of liver fibrosis following acute hepatitis C virus infection in HIV-positive MSM. AIDS, 33(5), 833–844. doi:10.1097/qad.0000000000002138