Presentation Abstract

Session: 102-HBV and HCV Alone and in Co-Infection with HIV
Sunday, Sep 18, 2011, 11:15 AM - 1:15 PM
Presentation Title: H3-810 - Liver Stiffness (LS) Change in HIV-Hepatitis C (HCV) Coinfected Patients Treated with CCR5 Inhibitor Based Antiretroviral Therapy
Location: Exhibit Hall F1
Poster Board Number: 300
Presentation Number: H3-810
Pres. Time: Sunday, Sep 18, 2011, 11:15 AM - 1:15 PM
Category: H3
Keywords: CCR5 inhibitor; HCV coinfection; Liver stiffness
Author(s): P. Nasta, MD - Medical doctor, F. Gatti - Medical doctor, F. Borghi - Medical doctor, E. Chiari, Medical Doctor - Medical doctor, A. Paderni - Medical doctor, G. Carosi - Prof;
Univ. of Brescia, Brescia, Italy.
Financial Disclosures:  P. Nasta, None..
F. Gatti, None..
F. Borghi, None..
E. Chiari, None..
A. Paderni, None..
G. Carosi, None.
Abstract: Background: In HIV/HCV patients (pts) LSP is faster than in HCV-monoinfected. chemokine receptor CCR5 is expressed on stellate cells in liver and it is strongly upregulated in experimental mouse models of fibrogenesis. Moreover CCR5 inhibition reduces liver fibrosis in experimental cirrhosis . The influence of CCR5 inhibition due to Maraviroc on liver stiffness (LS) change in HIV/HCV coinfected persons has been investigated. Methods: HIV/HCV pts,anti HCV treatment naïve, on stable effective HAART with atazanavir /ritonavir 300/100 mg + tenofovir/emtricitabina QD and Child-Pugh score <A6 were enrolled in a 96 weeks(W), prospective, randomized , pilot study. LS has been evaluated with biochemical markers of liver fibrosis and transient elastometry, performed by standard methods. Eligible subjects have been randomized 1:1 to maintain the current regimen (arm A) or to add MVC 150 mg BID (arm B). Clinical, virologic, immunologic, hepatic and metabolic parameters are recorded at baseline(BL) and every three months. LS was measured every 24W and staged following the standardized categories I:<7.1 kPa; II:7.1-9.4; III:9.5-12.4; IV:≥12.5. A preliminary 24 W analysis has been assessed. The Mann Whitney/Wilcoxon test has been used to compare the median of LS variations from BL through 24W in two groups. Results: Up to April 2011, 62 pts were enrolled: 30 in arm B,80% males, median age 46 (IQR 43-49)years, CD4 486 (405-654)cell/mm3, AST 43(31-59)IU/ml, ALT 68(45-92)IU/ml, HCV 5,8(5,4-6,2)log10 IU/ml. LS was 7,2 kPa (5,4-10,1) in arm B and 6,8 kPa (5,6-8,1) in arm A (p=NS). Twenty four subjects achieved week 24 (12 patients in each arm). From BL to week 24 LS decreased [-0.5(-1.7;+1,9)]in subjects enrolled in arm B (p=0.03) and increased [+ 0.35 KPa(-0.2;+1.4)] in subjects enrolled arm A. Six of 24 patients ( 3 in arm A and 3 in arm B) (25%) changed the stage of LS : 3 pts in arm B had a LS improvement switching from stage III to stage II ; 3 patients enrolled in arm A had a LS worsening, switching from stage I to stage II. Conclusion: To add MVC to the current HAART may reduce LS in HIV/HCV coinfected subjects




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