scholarly journals Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) Dynamics during HCV Treatment in HCV/HIV Coinfection

2003 ◽  
Vol 188 (10) ◽  
pp. 1498-1507 ◽  
Author(s):  
Francesca J. Torriani ◽  
Ruy M. Ribeiro ◽  
Tari L. Gilbert ◽  
Uschi M. Schrenk ◽  
Marietta Clauson ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hcv Treatment ◽  
Hiv Dynamics ◽  
Hiv Coinfection ◽  
Immunodeficiency Virus

Liver Stiffness–Based Strategies Predict Absence of Variceal Bleeding in Cirrhotic Hepatitis C Virus–Infected Patients With and Without Human Immunodeficiency Virus Coinfection After Sustained Virological Response

2020 ◽  
Author(s):  
Anaïs Corma-Gómez ◽  
Juan Macías ◽  
Luis Morano ◽  
Antonio Rivero ◽  
Francisco Téllez ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Sustained Virological Response ◽  
Virological Response ◽  
Variceal Bleeding ◽  
Liver Stiffness ◽  
Low Risk ◽  
Hiv Coinfection ◽  
Immunodeficiency Virus

Abstract Background In the setting of hepatitis C virus (HCV) active infection, liver stiffness (LS)–based strategies identify patients with low risk of developing esophageal variceal bleeding (VB) episodes, in whom unnecessary upper esophagogastroduodenoscopy (UGE) screening can be safely avoided. However, after sustained virological response (SVR), data on the accuracy of the criteria predicting this outcome in HCV-infected patients with cirrhosis, with or without human immunodeficiency virus (HIV) coinfection, are very limited. Methods This was a multicenter prospective cohort study, where HCV-monoinfected patients and HIV/HCV-coinfected individuals were included if they had (1) SVR with direct-acting antiviral–based therapy; (2) LS ≥9.5 kPa previous to treatment; and (3) LS measurement at the SVR time-point ≥14 kPa. Diagnostic accuracy of HEPAVIR, expanded Baveno VI, and HIV cirrhosis criteria, at the time of SVR, was evaluated. Missed VB episodes, negative predictive values (NPVs), and number of spared UGEs were specifically assessed. Results Four hundred thirty-five patients were included, 284 (65%) coinfected with HIV. Seven (1.6%) patients developed a first episode of VB after SVR. In patients without a previous VB episode, HEPAVIR, expanded Baveno VI and HIV cirrhosis criteria achieved NPV for first VB episode after SVR of 99.5% (95% confidence interval [CI], 97.1%–100%), 100% (95% CI 97.8%–100%), and 100% (95% CI 98%–100%) while sparing 45%, 39%, and 44% of UGEs, respectively. When considering HIV coinfection, the performance of the 3 criteria was similar, both in HCV-monoinfected and HIV/HCV-coinfected individuals. Conclusions After SVR, predictive LS-based strategies accurately identify HCV-infected patients, HIV coinfected or not, with low risk of developing VB during follow-up. In these specific patients, using HIV cirrhosis criteria maximize the number of spared UGEs while missing no VB episode.

scholarly journals Hepatitis C treatment uptake and response among human immunodeficiency virus/hepatitis C virus-coinfected patients in a large integrated healthcare system

2019 ◽  
Vol 30 (7) ◽  
pp. 689-695 ◽  
Author(s):  
Jennifer O Lam ◽  
Leo B Hurley ◽  
Scott Chamberland ◽  
Jamila H Champsi ◽  
Laura C Gittleman ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Drug Abuse ◽  
Cell Count ◽  
Hcv Treatment ◽  
Cd4 Cell Count ◽  
Treatment Uptake ◽  
Immunodeficiency Virus ◽  
Cd4 Cell

U.S. guidelines recommend that patients coinfected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) be prioritized for HCV treatment with direct-acting antiviral agents (DAAs), but the high cost of DAAs may contribute to disparities in treatment uptake and outcomes. We evaluated DAA initiation and effectiveness in HIV/HCV-coinfected patients in a U.S.-based healthcare system during October 2014–December 2017. Of 462 HIV/HCV-coinfected patients, 276 initiated DAAs (70% cumulative proportion treated over three years). Lower likelihood of DAA initiation was observed among patients with Medicare (government-sponsored insurance) versus commercial insurance (adjusted rate ratio [aRR] = 0.62, 95% CI = 0.46–0.84), patients with drug abuse diagnoses (aRR = 0.72, 95% CI = 0.54–0.97), patients with CD4 cell count <200 cells/µl versus ≥500 (aRR = 0.45, 95% CI = 0.23–0.91), and patients without prior HCV treatment (aRR = 0.68, 95% CI = 0.48–0.97). There were no significant differences in DAA initiation by age, gender, race/ethnicity, socioeconomic status, HIV transmission risk, alcohol use, smoking, fibrosis level, HIV RNA levels, antiretroviral therapy use, hepatitis B infection, or number of outpatient visits. Ninety-five percent of patients achieved sustained virologic response (SVR). We found little evidence of sociodemographic disparities in DAA initiation among HIV/HCV-coinfected patients, and SVR rates were high. Efforts are needed to increase DAA uptake among coinfected Medicare enrollees, patients with drug abuse diagnoses, patients with low CD4 cell count, and patients receiving first-time HCV treatment.

scholarly journals Liver Cirrhosis as a Risk Factor for Direct-Acting Antiviral Therapy Failure in Real-Life Hepatitis C Virus/Human Immunodeficiency Virus Coinfection

2017 ◽  
Vol 4 (3) ◽  
Author(s):  
Christoph Boesecke ◽  
Patrick Ingiliz ◽  
Florian Berger ◽  
Thomas Lutz ◽  
Knud Schewe ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Liver Cirrhosis ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Treatment Guidelines ◽  
Real Life ◽  
Direct Acting Antiviral ◽  
Hiv Coinfection ◽  
Immunodeficiency Virus ◽  
Direct Acting

Abstract Current hepatitis C virus (HCV) treatment guidelines recommend treating HCV/human immunodeficiency virus (HIV)-coinfected individuals similar to HCV-monoinfected individuals. Recently inferior response rates to direct acting antiviral (DAA) therapy in HCV/HIV coinfection have been reported. Our German hepatitis C cohort (GECCO) cohort data show that coinfected patients with liver cirrhosis are less likely to achieve viral eradication.

scholarly journals Barriers to Hepatitis C Virus (HCV) Treatment Initiation in Patients With Human Immunodeficiency Virus/HCV Coinfection: Lessons From the Interferon Era

2017 ◽  
Vol 4 (1) ◽  
Author(s):  
Tanyaporn Wansom ◽  
Oluwaseun Falade-Nwulia ◽  
Catherine G. Sutcliffe ◽  
Shruti H. Mehta ◽  
Richard D. Moore ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Treatment Initiation ◽  
Incidence Density ◽  
Hcv Treatment ◽  
Major Barrier ◽  
Treatment Uptake ◽  
Immunodeficiency Virus ◽  
Missed Visits

Abstract Background Hepatitis C is a major cause of mortality among human immunodeficiency virus (HIV)-infected patients, yet hepatitis C virus (HCV) treatment uptake has historically been low. Although the removal of interferon removes a major barrier to HCV treatment uptake, oral therapies alone may not fully eliminate barriers in this population. Methods Within the Johns Hopkins Hospital HIV cohort, a nested case-control study was conducted to identify cases, defined as patients initiating HCV treatment between January 1996 and 2013, and controls, which were selected using incidence density sampling (3:1 ratio). Controls were matched to cases on date of enrollment. Conditional logistic regression was used to evaluate factors associated with HCV treatment initiation. Results Among 208 treated cases and 624 untreated controls, the presence of advanced fibrosis (odds ratio [OR], 2.23; 95% confidence interval [CI], 1.26–3.95), recent active drug use (OR, 0.36; 95% CI, 0.19–0.69), and non-black race (OR, 2.01; 95% CI, 1.26–3.20) were independently associated with initiation of HCV therapy. An increasing proportion of missed visits was also independently associated with lower odds of HCV treatment (25%–49% missed visits [OR, 0.49; 95% CI, 0.27–0.91] and ≥50% missed visits [OR, 0.24; 95% CI, 0.12–0.48]). Conclusions Interferon-free treatments may not be sufficient to fully overcome barriers to HCV care in HIV-infected patients. Interventions to increase engagement in care for HIV and substance use are needed to expand HCV treatment uptake.

Prevalence of cryoglobulinemia in hepatitis C virus (HCV) positive patients with and without human immunodeficiency virus (HIV) coinfection

2004 ◽  
Vol 31 (3) ◽  
pp. 210-214 ◽  
Author(s):  
Charlene S. Dezzutti ◽  
Jacquie Astemborski ◽  
David L. Thomas ◽  
James H. Marshall ◽  
Thania Cabrera ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hiv Coinfection ◽  
Immunodeficiency Virus

scholarly journals CD4 T Lymphocyte Proliferative Responses to Hepatitis C Virus (HCV) Antigens in Patients Coinfected with HCV and Human Immunodeficiency Virus Who Responded to Anti‐HCV Treatment

2002 ◽  
Vol 186 (3) ◽  
pp. 302-311 ◽  
Author(s):  
Elisabeth Legrand ◽  
Didier Neau ◽  
Tatiana Galperine ◽  
Pascale Trimoulet ◽  
Jean‐François Moreau ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
T Lymphocyte ◽  
Hcv Treatment ◽  
Immunodeficiency Virus
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