The macrophage activation markers sCD206 and sCD163 predict mortality in patients with liver cirrhosis without or with acute-on-chronic liver failure (ACLF)

Child–Pugh A/B/C: 87/10/3%; 86% with HIV-RNA u003c50 copies/mL; 104 on continuous antiretroviral treatment (cART); median CD4 at baseline: 462/mm [IQR: 265–628]). History of previous HCV treatment was: naive 28%, treatment failure with PegIFN+Ribavirin (PR) 57%, treatment failure with PR+first generation protease inhibitor 11%, treatment failure with PR+others 4%. HCV genotype (Gt) were 1a (32%), 1b (12%), 1 other (10%), 2 (4%), 3 (19%) and 4 (23%). Four regimens were used: SOF+R in 22 patients (Gt1 28%; Gt2 18%; Gt3 36%; Gt4 18%), SOF+daclatasvir±R in 75 (Gt1 64%; Gt3 15%; Gt4 21%), SOF+ledipasvir in 3 (2 Gt1 and 1 Gt3) and SOF+simeprevir in 6 (2 Gt1 and 4 Gt4). On February 24th, 2015, 100%, 77%, 69% and 42% of the patients reached W4, EOT, and W4 and W12 posttreatment, respectively. No premature stop of DAA was reported in relation with tolerance or efficiency. Adverse events were reported in 22 patients (digestive 5%, anemia 36%, asthenia 14%, others 45%), and R was stopped in 3 patients and dose-adjusted in 9. During treatment and post-treatment period, clinical events in relation with cirrhosis were reported in 8% (hepatocellular carcinoma in 2 and decompensation in 5) and with HIV in 4% of the patients. VR was observed in 52% of the patients at W4, 100% at EOT. SVR4 and SVR12 were 100% and 93% for the patients reaching this endpoint, respectively. Conclusions: In this prospective real-life cohort, new all-oral DAA regimens were well tolerated and associated with very encouraging virological efficacy in cirrhotic HIV–HCV coinfected patients. This should not alleviate the surveillance for liver-related events in these patients.