Busca Arenzana Carmen, González-García Juan, Blas-García Ana, Esplugues Juan V, Olveira Martín Antonio, Montes Ramírez Maria Luisa
Unidad VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain.
Unidad VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain.
Enferm Infecc Microbiol Clin (Engl Ed). 2024 Feb;42(2):74-79. doi: 10.1016/j.eimce.2022.08.015. Epub 2023 Feb 1.
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.
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.
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 -0.8kPa in non-RPV-exposed patients (p=0.254) and -1.6kPa 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, -2.8kPa [p<0.001]; non-RPV-exposed, -1.1kPa [p=0.22]).
RPV-based antiretroviral regimens significantly reduced liver stiffness, as measured by TE, in patients cured of chronic hepatitis C.
利匹韦林（RPV）是一种抗逆转录病毒药物，具有良好的耐受性和有利的肝脏安全性。最近的研究表明，RPV可改善各种慢性肝病动物模型中的肝纤维化。我们的研究旨在通过使用瞬时弹性成像评估肝脏硬度变化来分析RPV对肝纤维化的影响。
对暴露于和未暴露于RPV的HIV感染患者进行回顾性队列研究。分析并比较了在两次瞬时弹性成像测量期间暴露于和未暴露于RPV的患者肝脏硬度的变化。
我们选择了118例暴露于RPV和118例未暴露于RPV的HIV感染患者。瞬时弹性成像（TE）测量之间的中位时间为50（29 - 68）个月。基于主要临床特征的重复测量一般线性模型显示，未暴露于RPV的患者TE值显著降低-0.8kPa（p = 0.254），暴露于RPV的组中降低-1.6kPa（p < 0.001）。亚组分析显示，仅丙型肝炎治愈的患者TE值显著降低（暴露于RPV的患者，-2.8kPa [p < 0.001]；未暴露于RPV的患者，-1.1kPa [p = 0.22]）。
在慢性丙型肝炎治愈的患者中，基于RPV的抗逆转录病毒方案通过TE测量显著降低了肝脏硬度。
