HCV and HIV coinfection - technical, relevant info is highlighted. This can be a big market for the HP just like ESRD.
Treatment of hepatitis C virus (HCV) infection in patients coinfected with HIV in the HIV Outpatient Study (HOPS), 1999-2007
Authors: Vellozzi, C.1; Buchacz, K.1; Baker, R.2; Spradling, P. R.3; Richardson, J.2; Moorman, A.3; Tedaldi, E.4; Durham, M.1; Ward, J.3; Brooks, J. T.1
Source: Journal of Viral Hepatitis, Volume 18, Number 5, May 2011 , pp. 316-324(
Abstract:
Summary.
Liver disease due to hepatitis C virus (HCV) infection is a leading cause of non-AIDS-related morbidity and mortality in patients infected with HIV. We assessed the frequency of and predictors for initiation of treatment for HCV infection among patients coinfected with HCV/HIV enrolled in the HIV Outpatient Study (HOPS) during 1999-2007. We included patients with confirmed HCV infection, at least 1?year of subsequent follow-up, and no evidence of prior HCV treatment. We assessed predictors of HCV treatment initiation using Cox proportional hazards analyses. During 1999-2007, 103 (20%) HOPS patients coinfected with HCV/HIV initiated HCV treatment during a median of 4.3?years of follow-up (interquartile range: 2.7, 6.7). In multivariable analysis, non-Hispanic black race/ethnicity (hazard ratio HR] 0.3; 95% confidence interval [CI]?=?0.2, 0.6) was independently associated with a lower likelihood of HCV treatment. Elevated alanine aminotransferase (ALT; HR 3.5; 95% CI?=?2.2, 5.6) and CD4+ cell count =500 cells/mm3 (HR 1.8; 95% CI?=?1.2, 2.8) at the start of observation were independently associated with higher likelihood of HCV treatment. For patients starting observation in 1999-2001, 2002-2004 and 2005-2007, 5%, 11% and 21% of patients initiated treatment during the first year of follow-up, respectively. Between 1999 and 2007, despite a stable low fraction of patients coinfected with HCV/HIV initiating treatment for HCV infection, an increasing proportion initiated treatment within the first year after the infection was confirmed. Treatment of HCV infection in patients coinfected with HCV/HIV should be considered a priority, given the increased risk of accelerated end-stage liver disease.
Keywords: HAART; HCV treatment; hepatitis C; HIV HCV; HIV infection; interferon
Document Type: Research article
DOI: 10.1111/j.1365-2893.2010.01299.x
Affiliations: 1: Division of HIV/AIDS Prevention, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 2: Cerner Corporation, Vienna, VA 3: Division of Viral Hepatitis, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 4: Temple University, Philadelphia, PA, USA
Publication date: 2011-05-01
