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<publisher>HAL CCSD</publisher>
<title lang=en>MELD Score Kinetics in Decompensated HIV+/HCV+ Patients: A Useful Prognostic Tool (ANRS HC EP 25 PRETHEVIC Cohort Study)</title>
<creator>Gelu-Simeon, Moana</creator>
<creator>Bayan, Tatiana</creator>
<creator>Ostos, Maria</creator>
<creator>Boufassa, Faroudy</creator>
<creator>Teicher, Elina</creator>
<creator>Steyaert, Jean-Marc</creator>
<creator>Bertucci, Inga</creator>
<creator>Anty, Rodolphe</creator>
<creator>Pageaux, Georges-Philippe</creator>
<creator>Meyer, Laurence</creator>
<creator>Duclos-Vallée, Jean-Charles</creator>
<contributor>Hôpital Paul Brousse ; Université Paris-Sud - Paris 11 (UP11) - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Paul Brousse</contributor>
<contributor>Institut de recherche, santé, environnement et travail [Rennes] (Irset) ; Université d'Angers (UA) - Université des Antilles et de la Guyane (UAG) - Université de Rennes 1 (UR1) - École des Hautes Études en Santé Publique [EHESP] (EHESP) - Institut National de la Santé et de la Recherche Médicale (INSERM) - Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )</contributor>
<contributor>Centre de recherche en épidémiologie et santé des populations (CESP) ; Université de Versailles Saint-Quentin-en-Yvelines (UVSQ) - Université Paris-Sud - Paris 11 (UP11) - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Paul Brousse - Institut National de la Santé et de la Recherche Médicale (INSERM)</contributor>
<contributor>Centre méditérannéen de médecine moléculaire (C3M) ; Université Nice Sophia Antipolis (UNS) ; Université Côte d'Azur (UCA) - Université Côte d'Azur (UCA) - Institut National de la Santé et de la Recherche Médicale (INSERM)</contributor>
<contributor>Département Digestif ; CHU Nice - Hôpital de l'Archet</contributor>
<contributor>Service d'hépatologie ; Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier) - Hôpital Saint Eloi</contributor>
<contributor>Biopathologie de la Myéline, Neuroprotection et Stratégies Thérapeutiques ; Institut National de la Santé et de la Recherche Médicale (INSERM) - Faculté de Médecine</contributor>
<contributor>Pathogénèse et traitement de l'hépatite fulminante et du cancer du foie ; Université Paris-Sud - Paris 11 (UP11) - Institut National de la Santé et de la Recherche Médicale (INSERM)</contributor>
<contributor>Centre hépato-biliaire (CHB) ; Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Paul Brousse - Institut National de la Santé et de la Recherche Médicale (INSERM)</contributor>
<contributor>Virus Hépatotropes et Cancers ; Université Paris-Sud - Paris 11 (UP11) - IFR89 - EA 3541</contributor>
<description>International audience</description>
<source>Medicine</source>
<identifier>hal-01205351</identifier>
<identifier>https://hal-univ-rennes1.archives-ouvertes.fr/hal-01205351</identifier>
<source>https://hal-univ-rennes1.archives-ouvertes.fr/hal-01205351</source>
<source>Medicine, 2015, 94 (30), pp.e1239. 〈10.1097/MD.0000000000001239〉</source>
<identifier>DOI : 10.1097/MD.0000000000001239</identifier>
<relation>info:eu-repo/semantics/altIdentifier/doi/10.1097/MD.0000000000001239</relation>
<identifier>PUBMED : 26222860</identifier>
<relation>info:eu-repo/semantics/altIdentifier/pmid/26222860</relation>
<language>en</language>
<subject>[SDV] Life Sciences [q-bio]</subject>
<type>info:eu-repo/semantics/article</type>
<type>Journal articles</type>
<description lang=en>To assess prognostic factors for survival and describe Model for End-Stage liver disease (MELD) dynamics in human immunodeficiency virus+/hepatitis C virus+ (HIV+/HCV+) patients after an initial episode of hepatic decompensation.An HIV+/HCV+ cohort of patients experiencing an initial decompensation episode within the year preceding enrollment were followed prospectively. Clinical and biological data were collected every 3 months. Predictors for survival were identified using Kaplan-Meier curves and Cox models. A 2-slope-mixed linear model was used to estimate MELD score changes as a function of survival.Sixty seven patients were included in 32 centers between 2009 and 2012 (72% male; median age: 48 years [interquartile ratio (IQR):45-52], median follow-up: 22.4 months [range: 0.5-65.3]). Overall survival rates were 86%, 78%, and 59% at 6, 12, and 24 months, respectively. Under multivariate analysis, the MELD score at initial decompensation was predictive of survival, adjusted for age, type of decompensation, baseline CD4 counts, and further decompensation during follow-up as a time-dependent variable. The adjusted hazard ratio of death was 1.32 for a score 3 points higher (95% CI: [1.06-1.63], P = 0.012). MELD score kinetics within the 6 months after initial decompensation differed significantly between non-deceased and deceased patients, with a decreased (-0.49/month; P = 0.016), versus a flat (+0.06/month, P = 0.753) mean change in score.MELD is an effective tool to predict survival in HIV+/HCV+ patients with decompensated cirrhosis. A non-decreasing MELD score within 6 months following this initial decompensation episode may benefit from privileged access to liver transplantation in this poor prognosis population</description>
<date>2015</date>
</dc>
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