Martín Carmona, JésicaCorma Gómez, AnaïsMoyano Murillo, José MaríaTéllez Pérez, Francisco de PaulaArenga Barrios, DoloresSerrano Fuentes, MiriamMorano Vázquez, Aitana CarlaCorona Mata, DianaNavarrete Lorite, Miguel NicolásVera Méndez, FranciscoBarroso, IsabelPalacios, RosarioSantos, Ignacio de losBelinchón, OlgaGalera, CarlosImaz, ArkaitzMerino, DoloresReus Bañuls, SergioGalindo, María JoséLópez Zuñiga, Miguel ÁngelPineda, Juan AntonioMacías, JuanGEHEP-011 Study Group2025-07-082025-07-082025-05-012589-5370https://hdl.handle.net/2445/222075Background After sustained virological response (SVR), liver stiffness (LS) usually decreases. However, information related to the impact of HIV co-infection in patients with advanced fibrosis is scarce. The aim was to analyze the impact of HIV co-infection on the LS dynamics after HCV cure. Methods Prospective study conducted in the GEHEP-011 multicenter cohort (initiated in October 2011-November 2023, ID NCT04460157), including patients with chronic HCV infection, with or without HIV co-infection, fulfilling: 1) SVR with direct-acting antivirals; 2) pre-treatment LS >= 9.5 kPa; 3) available measurement of LS at SVR. Pre-treatment, SVR and annual post-treatment LS were assessed. The primary outcome was time to LS normalization achievement (<= 7.2 kPa) in two consecutive examinations. Findings 1138 patients were included, 678 (60%) of whom were living with HIV (PLWH). The median time between the first to the last measure was 35 (17-69) months. In total, 390 [34% (95% confidence interval, 31%-37%)] patients achieved LS normalization, 169 [37% (CI 95%, 34%-43%)] individuals with HCV mono-infection vs. 221 [32% (CI 95%, 29%-36%)] PLWH achieved LS normalization (p = 0.003). The propensity score (PS) for HIV infection was calculated. In a multivariate model for competing risks (death was the competing event) adjusted for HIV, PS and diabetes, HIV infection was associated with a lower probability of achieving normalization [sHR = 0.82 (95% CI, 0.67-1.00), p = 0.045]. Matching by closer PS was performed. In the resultant subset, the probability of achieving LS normalization was again lower in PLWH [sHR = 0.76 (0.56-0.97), p < 0.001]. Interpretation After SVR, the probability of reaching LS normalization is significantly lower in PLWH. This could have implications on the development of long-term clinical events. Copyright (c) 2025 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/).10 p.application/pdfengcc-by-nc (c) Martín Carmona et al., 2025http://creativecommons.org/licenses/by-nc/3.0/es/Virus de l'hepatitis CInfeccions per VIHHepatitis C virusHIV infectionsinfo:eu-repo/semantics/article2025-06-26info:eu-repo/semantics/openAccess40474999