Abstract | BACKGROUND: METHODS: Haemodynamic parameters, including hepatic venous pressure gradient (HVPG), pulmonary arterial pressure (PAP(mean)), cardiac output (CO) and systemic vascular resistance (SysVR), were prospectively evaluated before and after PEG-IFN-α+RBV therapy in 80 HIV-HCV-coinfected patients. RESULTS: Baseline evaluation showed a mean HVPG of 4.7 mmHg, CO of 6.15 l/min and PAP(mean) of 14.8 mmHg. PHT was present in 26% of patients, hyperdynamic circulation in 5% and PAH in 4%. Patients with advanced fibrosis (METAVIR stage F3/F4; n=32) had significantly higher CO (P=0.008), lower SysVR (P=0.035), higher PAP(mean) (P=0.018) and higher pulmonary vascular resistance (P=0.022) than patients with stage F0-F2 fibrosis (n=48). Both hyperdynamic circulation and PAH were significantly associated with liver stiffness, fibrosis stage and portal pressure; a non-significant trend was found for CD4(+) T-cell counts and HIV RNA levels. No significant changes in PAP(mean), CO and SysVR were observed after PEG-IFN-α+RBV treatment, although a significant decrease in HVPG was noted in patients with HCV eradication (P=0.013). CONCLUSIONS: The overall prevalence of hyperdynamic circulation and PAH in HIV-HCV coinfection is low. Advanced fibrosis, increased liver stiffness, elevated portal pressure and probably CD4(+) T-cell count and HIV viraemia represent risk factors for hyperdynamic circulation and PAH. PHT is present in 26% of HIV-HCV-coinfected patients evaluated for antiviral therapy. Successful HCV eradication significantly decreases HVPG.
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Authors | Thomas Reiberger, Berit A Payer, Arnulf Ferlitsch, Wolfgang Sieghart, Florian Breitenecker, Maximilian C Aichelburg, Brigitte Schmied, Armin Rieger, Michael Trauner, Markus Peck-Radosavljevic, Vienna Hepatic Hemodynamic Lab and Vienna HIV & Liver Study Group |
Journal | Antiviral therapy
(Antivir Ther)
Vol. 17
Issue 7
Pg. 1327-34
( 2012)
ISSN: 2040-2058 [Electronic] England |
PMID | 22948263
(Publication Type: Journal Article)
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Chemical References |
- Anti-Retroviral Agents
- Interferon-alpha
- RNA, Viral
- Polyethylene Glycols
- Ribavirin
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Topics |
- Adult
- Anti-Retroviral Agents
(therapeutic use)
- CD4 Lymphocyte Count
- Cardiac Output
- Coinfection
(blood, drug therapy, virology)
- Familial Primary Pulmonary Hypertension
- Female
- HIV
(pathogenicity)
- HIV Infections
(blood, drug therapy, virology)
- Hemodynamics
- Hepacivirus
(pathogenicity)
- Hepatitis C, Chronic
(blood, drug therapy, virology)
- Humans
- Hypertension, Portal
(physiopathology)
- Hypertension, Pulmonary
(epidemiology, physiopathology)
- Interferon-alpha
(therapeutic use)
- Liver
(drug effects, physiopathology)
- Liver Cirrhosis
(physiopathology)
- Lung
(drug effects, physiopathology)
- Male
- Middle Aged
- Polyethylene Glycols
(therapeutic use)
- Prevalence
- Prospective Studies
- RNA, Viral
(blood)
- Ribavirin
(therapeutic use)
- Risk Factors
- Severity of Illness Index
- Treatment Outcome
- Viremia
(virology)
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