Lars Jørgen Østergaard

Liver-related death among HIV/hepatitis C virus-co-infected individuals: Implications for the era of directly acting antivirals

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

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  • Lars Peters, University of Copenhagen
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  • Juergen K. Rockstroh, University of Bonn
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  • Aza Rakmanova, Botkin Hospital of Infectious Diseases
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  • Tatiana Trofimova, Novgorod Centre for AIDS
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  • Karine Lacombe, Sorbonne Université
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  • Igor Karpov, Belarusian State Medical University
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  • Massimo Galli, Ospedale Luigi Sacco
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  • Pere Domingo, Autonomous University of Barcelona
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  • Ole Kirk, University of Copenhagen
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  • Jens D. Lundgren, University of Copenhagen
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  • Amanda Mocrofta, University College London
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  • K. Kostov, Klinicki Centar Univerziteta Sarajevo
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  • J. Begovac, Infectious Diseases Hospital
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  • L. Machala, University of Zagreb
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  • D. Sedlacek, Charles University
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  • C. Duvivier, Institut National de la Santé et de la Recherche Médicale
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  • J. Bogner, Goethe University Frankfurt
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  • G. Fätkenheuer, Ludwig Maximilian University of Munich
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  • N. Chkhartishvili, University of Cologne
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  • J. Kosmidis, AIDS and Clinical Immunology Research Center
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  • P. Gargalianos, AIDS and Clinical Immunology Research Center
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  • J. Perdios, AIDS and Clinical Immunology Research Center
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  • H. Sambatakou, Athens General Hospital
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  • M. Gottfredsson, Szent László Hospital
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  • F. Mulcahy, Landspitali University Hospital
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  • I. Yust, Trinity College Dublin
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  • D. Turner, Trinity College Dublin
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  • M. Burke, Trinity College Dublin
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  • M. Zaccarelli, University of Rome La Sapienza
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  • R. Acinapura, University of Rome La Sapienza
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  • G. D'Offizi, University of Rome La Sapienza
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  • A. Lazzarin, IRCCS Istituto per le Malattie Infettive Lazzaro Spallanzani - Roma
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  • A. Castagna, IRCCS Istituto per le Malattie Infettive Lazzaro Spallanzani - Roma
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  • N. Gianotti, IRCCS Istituto per le Malattie Infettive Lazzaro Spallanzani - Roma
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  • M. Galli, IRCCS San Raffaele Scientific Institute
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  • B. Rozentale, Ospedale Luigi Sacco
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  • V. Uzdaviniene, Infectology Centre of Latvia
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  • T. Staub, Lithuanian AIDS Centre
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  • R. Hemmer, Lithuanian AIDS Centre
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  • P. Reiss, Centre Hospitalier
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  • V. Ormaasen, University of Amsterdam
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  • A. Maeland, University of Amsterdam
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  • J. Bruun, University of Amsterdam
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  • B. Knysz, University of Oslo
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  • J. Gasiorowski, University of Oslo
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  • M. Inglot, University of Oslo
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  • A. Horban, Wroclaw Medical University
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  • E. Bakowska, Wroclaw Medical University
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  • A. Grzeszczuk, Centrum Diagnostyki i Terapii AIDS
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  • R. Flisiak, Centrum Diagnostyki i Terapii AIDS
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  • M. Parczewski, Medical University of Bialystok
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  • M. Pynka, Medical University of Bialystok
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  • K. Maciejewska, Medical University of Bialystok
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  • M. Beniowski, Pomeranian Medical University in Szczecin
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  • E. Mularska, Pomeranian Medical University in Szczecin
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  • T. Smiatacz, Osrodek Diagnostyki i Terapii AIDS
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  • E. Jablonowska, Medical University of Gdansk
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  • E. Malolepsza, Medical University of Gdansk
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  • K. Wojcik, Medical University of Gdansk
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  • I. Mozer-Lisewska, Wojewodzki Szpital Specjalistyczny
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  • M. Doroana, University of Medical Sciences Poznan
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  • L. Caldeira, University of Medical Sciences Poznan
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  • K. Mansinho, University of Lisbon
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  • F. Maltez, Santa Cruz Hospital
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  • R. Radoi, Hospital Curry Cabral
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  • C. Oprea, Hospital Curry Cabral
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  • Victor Babes, Spitalul de Boli Infectioase Si Tropicale
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  • A. Rakhmanova
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  • A. Rakhmanova, Medical Academy Botkin Hospital
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  • T. Trofimora, St Petersburg AIDS Centre
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  • I. Khromova, Novgorod Centre for AIDS
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  • E. Kuzovatova, Centre for HIV/AIDS and infectious diseases
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  • D. Jevtovic, Nizhny Novgorod Scientific and Research Institute
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  • A. Shunnar, Institute for Infectious and Tropical Diseases
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  • D. Staneková, Institute for Infectious and Tropical Diseases
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  • J. Tomazic, Dérer Hospital
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  • M. Gutierrez, University of Barcelona
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  • M. A. Sambeat, University of Barcelona
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  • R. Weber
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  • A. Calmy, University of Lausanne
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  • H. Furrer, University of Geneva
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  • M. Battegay, University of Bern
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  • L. Elzi, University of Bern
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  • P. Schmid, University of Basel
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  • E. Kravchenko, Department of Radiology and Nuclear Medicine Kantonsspital St. Gallen
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  • G. Kutsyna, Kiev Centre for AIDS
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  • S. Servitskiy, Luhansk State Medical University
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  • G. Kyselyova, Kharkiv National Medical University
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  • A. M. Johnson, St. Stephen's Clinic, Imperial College London
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  • E. Simons, Imperial College London
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  • S. Edwards, St. Stephen's Clinic, Imperial College London
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  • A. Phillips, University College London
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  • M. A. Johnson, University College London
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  • A. Mocroft, University College London
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  • C. Orkin, University College London
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  • J. Weber, Barts Health NHS Trust
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  • G. Scullard, Barts Health NHS Trust
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  • M. Fisher, Imperial College School of Medicine at St. Mary's
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  • C. Leen, Brighton and Sussex University Hospitals NHS Trust

Background: Potent, less toxic, directly acting antivirals (DAAs) for treatment of hepatitis C virus (HCV) infection promise to improve HCV cure rates among HIV/ HCV-co-infected individuals. However, the costs of treatment will necessitate prioritization of those at greatest risk of liver-related death (LRD) for therapy. This study aims to provide guidance on who should be prioritized for DAA treatment. Methods: Three thousand, nine hundred and forty-one HCV antibody-positive PSHREG and FIB-4 are names not acronyms (EuroSIDA) patients with follow-up after 1 January 2000 were included, with causes of death classified using Coding causes of Death in HIV (CoDe) methodology. Crude death rates, competing-risks Cox proportional- hazards models and cumulative incidence functions were used to describe factors associated with LRD. Results: LRD accounted for 145 of 670 (21.6%) deaths in the study population. LRD rates peaked in those aged 35'45 years, and occurred almost exclusively in those with at least F2 fibrosis at baseline. In adjustedCoxmodels, risk factors for LRDincluded F4 or F2/F3 fibrosis [sub-distribution hazard ratio (sHR) 6.3, 95%confidence interval (CI)4.1'9.6; andsHR2.5, 95%CI 1.5'4.2 vs. F0/F1, respectively), CD4 cell count (sHR 0.83, 95%CI 0.73'0.95 per doubling) and hepatitis B surface antigen-positive (sHR 2.2, 95% CI 1.3'3.5 vs. hepatitis B surface antigen-negative). The 5-year probability of LRD was low in those with F0/F1 fibrosis (sHR2.2%, 95%CI 1.7''2.9), but substantial in those withF2/F3 and F4 fibrosis (sHR 10.3%, 95% CI 7.6'13.5; and sHR 14.0%, 95% CI 10.3'18.3, respectively). Conclusion: Treatment with DAAs should be prioritized for those with at least F2 fibrosis. Early initiation of cART with the aim of avoiding low CD4 cell counts should be considered essential to decrease the risk of LRD and the need for HCV treatment.

Original languageEnglish
JournalAIDS
Volume29
Issue10
Pages (from-to)1205-1215
Number of pages11
ISSN0269-9370
DOIs
Publication statusPublished - 19 Jun 2015

    Research areas

  • Causes of death, Directly acting antivirals, HIV/HCV co-infection, Liver fibrosis, Liver-related death

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