Benefits of rilpivirine for liver stiffness in HIV/HCV-coinfected patients

Background: Rilpivirine (RPV) is an antiretroviral drug characterized by good tolerability and a favorable liver safety profile. Recent research has shown that RPV ameliorates liver fibrosis in animal models of various chronic liver diseases. Our study aimed to analyze the effect of RPV on liver fibrosis by assessing changes in liver stiffness using transient elastography. Methods: Retrospective cohort study of HIV -infected patients who were exposed and not exposed to RPV. The change in liver stiffness during the period between two transient elastography measurements was analyzed and compared for patients exposed and not exposed to RPV. Results: We selected 118 RPV-exposed and 118 non-RPV-exposed HIV -infected patients. Median time between transient elastography (TE) measurements was 50 (29-68) months. A repeated -measures general linear model based on the main clinical characteristics revealed a significant decrease in the TE value of -0.8 kPa in non-RPV-exposed patients (p = 0.254) and -1.6 kPa in the RPV-exposed group (p < 0.001). The subgroup analysis showed a significant reduction in the TE value only patients cured of hepatitis C (RPV-exposed, -2.8 kPa [p < 0.001]; non-RPV-exposed, -1.1 kPa [p = 0.22]). Conclusion: RPV-based antiretroviral regimens significantly reduced liver stiffness, as measured by TE, in patients cured of chronic hepatitis C. (c) 2022 Sociedad Espaniola de Enfermedades Infecciosas y Microbiologia Clinica. Published by Elsevier Espania, S.L.U. All rights reserved.