Clinical Outcomes in Persons Coinfected With Human Immunodeficiency Virus and Hepatitis C Virus: Impact of Hepatitis C Virus Treatment

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DOI

  • Amanda Mocroft, University College London
  • ,
  • Jens Lundgren, Rigshospitalet
  • ,
  • Jan Gerstoft, Rigshospitalet
  • ,
  • Line D Rasmussen, Odense University Hospital
  • ,
  • Sanjay Bhagani, Royal Free Hospital, London
  • ,
  • Inka Aho, Helsinki University Hospital
  • ,
  • Christian Pradier, Department of Public Health, Centre Hospitalier Universitaire de Nice, France.
  • ,
  • Johannes R Bogner, Ludwig-Maximilians-University of Munich Medical Centre
  • ,
  • Christina Mussini, University of Modena and Reggio Emilia
  • ,
  • Caterina Uberti Foppa, Vita-Salute San Raffaele University
  • ,
  • Fernando Maltez, Hospital de Curry Cabral, Serviço de Doenças Infecciosas, Lisbon, Portugal.
  • ,
  • Montse Laguno, University of Barcelona
  • ,
  • Gilles Wandeler, University of Bern
  • ,
  • Karolin Falconer, Karolinska University Hospital
  • ,
  • Tatyana Trofimova, Novgorod Centre for Acquired Immunodeficiency Syndrome Prevention and Control, Novgorod the Great, Russia.
  • ,
  • Elena Borodulina, Samara State Medical University
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  • Djordje Jevtovic, Belgrade University School of Medicine
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  • Elzbieta Bakowska, Wojewodzki Szpital Zakazny, Warsaw, Poland.
  • ,
  • Kerstin Kase, Centre of Infectious Diseases, West-Tallin Central Hospital, Tallin, Estonia.
  • ,
  • Galina Kyselyova, Crimean Republican Acquired Immunodeficiency Syndrome Centre, Simferopol.
  • ,
  • Richard Haubrich, Gilead Sciences Inc., Foster City, California.
  • ,
  • Jürgen K Rockstroh, University Hospital Bonn
  • ,
  • Lars Peters, Rigshospitalet
  • ,
  • EuroSIDA study

BACKGROUND: A hepatitis C (HCV) cure is associated with changes in lipids and inflammatory biomarkers, but its impact on clinical endpoints among treated human immunodeficiency virus (HIV)/HCV coinfected persons is unclear.

METHODS: People living with HIV from EuroSIDA with a known HCV status after January 2001 were classified into strata based on time-updated HCV RNA measurements and HCV treatment, as either HCV antibody-negative; spontaneously resolved HCV; chronic, untreated HCV; cured HCV (HCV RNA-negative); or HCV treatment failures (HCV RNA-positive). Poisson regression was used to compare incidence rates between HCV groups for end-stage liver disease (ESLD; including hepatocellular carcinoma [HCC]), non-acquired immunodeficiency virus defining malignancy (NADM; excluding HCC), and cardiovascular disease (CVD).

RESULTS: There were 16 618 persons included (median follow-up 8.3 years, interquartile range 3.1-13.7). There were 887 CVD, 902 NADM, and 436 ESLD events; crude incidence rates/1000 person-years follow-up were 6.4 (95% confidence interval [CI] 6.0-6.9) for CVD, 6.5 (95% CI 6.1-6.9) for NADM, and 3.1 (95% CI 2.8-3.4) for ESLD. After adjustment, there were no differences in incidence rates of NADM or CVD across the 5 groups. HCV-negative individuals (adjusted incidence rate ratio [aIRR] 0.22, 95% CI 0.14-0.34) and those with spontaneous clearance (aIRR 0.61, 95% CI 0.36-1.02) had reduced rates of ESLD compared to cured individuals. Persons with chronic, untreated HCV infections (aIRR 1.47, 95% CI 1.02-2.13) or treatment failure (aIRR 1.80, 95% CI 1.22-2.66) had significantly raised rates of ESLD, compared to those who were cured.

CONCLUSIONS: Incidences of NADM or CVD were independent of HCV group, whereas those cured had substantially lower incidences of ESLD, underlining the importance of successful HCV treatment for reducing ESLD.

OriginalsprogEngelsk
TidsskriftClinical Infectious Diseases
Vol/bind70
Nummer10
Sider (fra-til)2131-2140
Antal sider10
ISSN1058-4838
DOI
StatusUdgivet - maj 2020

Bibliografisk note

© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

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