Antiretroviral Therapy and Sustained Virological Response to HCV Therapy are Associated with Slower Liver Fibrosis Progression in HIV–HCV-Coinfected Patients: Study from the Anrs Co 13 Hepavih Cohort

Loko, Marc-Arthur; Bani‐Sadr, Firouzé; Valantin, Marc‐Antoine; Lascoux-Combe, Caroline; Fontaine, Hélène; Bonnard, Philippe; Gervais, Anne; Bouchaud, Olivier; Garipuy, D.; Quertainmont, Yann; Vittecoq, D.; Tehrani, Michka Shoai; Winnock, María; Dabis, François; Salmon, Dominique

doi:10.3851/imp2419

Cited by 26 publications

(29 citation statements)

References 38 publications

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“…Earlier ART in individuals co-infected with HCV is associated with slower progression of hepatic fibrosis and reduced risk of liver disease progression [30,31]. Our results showed that patients with HCV co-infection had a higher mortality compared to those who had only HIV infection.…”

Section: Discussionmentioning

confidence: 66%

Trends of CD4 cell count levels at the initiation of antiretroviral therapy over time and factors associated with late initiation of antiretroviral therapy among Asian HIV‐positive patients

Kiertiburanakul

Boettiger

Lee

et al. 2014

Journal of the International AIDS Society

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IntroductionAlthough antiretroviral therapy (ART) has been rapidly scaled up in Asia, most HIV-positive patients in the region still present with late-stage HIV disease. We aimed to determine trends of pre-ART CD4 levels over time in Asian HIV-positive patients and to determine factors associated with late ART initiation.MethodsData from two regional cohort observational databases were analyzed for trends in median CD4 cell counts at ART initiation and the proportion of late ART initiation (CD4 cell counts <200 cells/mm3 or prior AIDS diagnosis). Predictors for late ART initiation and mortality were determined.ResultsA total of 2737 HIV-positive ART-naïve patients from 22 sites in 13 Asian countries and territories were eligible. The overall median (IQR) CD4 cell count at ART initiation was 150 (46–241) cells/mm3. Median CD4 cell counts at ART initiation increased over time, from a low point of 115 cells/mm3 in 2008 to a peak of 302 cells/mm3 after 2011 (p for trend 0.002). The proportion of patients with late ART initiation significantly decreased over time from 79.1% before 2007 to 36.3% after 2011 (p for trend <0.001). Factors associated with late ART initiation were year of ART initiation (e.g. 2010 vs. before 2007; OR 0.40, 95% CI 0.27–0.59; p<0.001), sex (male vs. female; OR 1.51, 95% CI 1.18–1.93; p=0.001) and HIV exposure risk (heterosexual vs. homosexual; OR 1.66, 95% CI 1.24–2.23; p=0.001 and intravenous drug use vs. homosexual; OR 3.03, 95% CI 1.77–5.21; p<0.001). Factors associated with mortality after ART initiation were late ART initiation (HR 2.13, 95% CI 1.19–3.79; p=0.010), sex (male vs. female; HR 2.12, 95% CI 1.31–3.43; p=0.002), age (≥51 vs. ≤30 years; HR 3.91, 95% CI 2.18–7.04; p<0.001) and hepatitis C serostatus (positive vs. negative; HR 2.48, 95% CI 1.−4.36; p=0.035).ConclusionsMedian CD4 cell count at ART initiation among Asian patients significantly increases over time but the proportion of patients with late ART initiation is still significant. ART initiation at higher CD4 cell counts remains a challenge. Strategic interventions to increase earlier diagnosis of HIV infection and prompt more rapid linkage to ART must be implemented.

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Section: Discussionmentioning

confidence: 66%

Trends of CD4 cell count levels at the initiation of antiretroviral therapy over time and factors associated with late initiation of antiretroviral therapy among Asian HIV‐positive patients

Kiertiburanakul

Boettiger

Lee

et al. 2014

Journal of the International AIDS Society

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“…Large clinical trials comparing pretreatment and posttreatment liver biopsies have previously shown improvements in inflammation as well as in fibrosis scores following HCV SVR. A [9,19,20] recent meta-analysis of six studies with a total of 443 HCV-monoinfected cirrhotic patients showed that SVR was associated with almost a three-fold higher chance of cirrhosis regression, as shown by liver biopsy [21].…”

Section: Discussionmentioning

confidence: 98%

Regression of liver stiffness after sustained hepatitis C virus (HCV) virological responses among HIV/HCV-coinfected patients

2015

Aids

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“…Hazardous alcohol use exacerbates HCV-related liver disease through increased HCV viral replication, toxic effects on the liver, and indirectly via effects on ART adherence and decreased HCV treatment eligibility[47–51]. In addition, alcohol use among PLWH co-infected with HCV is associated with faster liver fibrosis progression, while sustained virological response to HCV therapy is associated with slower liver fibrosis progression[52]. HCV treatment is rapidly evolving with higher treatment success rates and easier treatment regimens, however alcohol use remains a potential contraindication to HCV treatment among PLWH[53].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Factors Associated with Hazardous Alcohol Use Among Persons Living with HIV Across the US in the Current Era of Antiretroviral Treatment

et al. 2017

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Hazardous alcohol use is associated with detrimental health outcomes among persons living with HIV (PLWH). We examined the prevalence and factors associated with hazardous alcohol use in the current era using several hazardous drinking definitions and binge drinking defined as ≥5 drinks for men vs. ≥4 for women. We included 8567 PLWH from 7 U.S. sites from 2013–2015. Current hazardous alcohol use was reported by 27% and 34% reported binge drinking. In adjusted analyses, current and past cocaine/crack (odd ratio [OR] 4.1:3.3–5.1, p<0.001 and OR 1.3:1.1–1.5, p<0.001 respectively), marijuana (OR 2.5:2.2–2.9, p<0.001 and OR 1.4:1.2–1.6, p<0.001), and cigarette use (OR 1.4:1.2–1.6, p<0.001 and OR 1.3:1.2–1.5, p<0.001) were associated with increased hazardous alcohol use. The prevalence of hazardous alcohol use remains high in the current era, particularly among younger men. Routine screening and targeted interventions for hazardous alcohol use, potentially bundled with interventions for other drugs, remain a key aspect of HIV care.

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Antiretroviral Therapy and Sustained Virological Response to HCV Therapy are Associated with Slower Liver Fibrosis Progression in HIV–HCV-Coinfected Patients: Study from the Anrs Co 13 Hepavih Cohort

Abstract: Our findings show that long-term ART and achieving sustained virological response in HIV-HCV-coinfected patients are both significantly associated with lack of increase in LS over a 33-month period.

Cited by 26 publications

References 38 publications

Trends of CD4 cell count levels at the initiation of antiretroviral therapy over time and factors associated with late initiation of antiretroviral therapy among Asian HIV‐positive patients

Trends of CD4 cell count levels at the initiation of antiretroviral therapy over time and factors associated with late initiation of antiretroviral therapy among Asian HIV‐positive patients

Regression of liver stiffness after sustained hepatitis C virus (HCV) virological responses among HIV/HCV-coinfected patients

Prevalence and Factors Associated with Hazardous Alcohol Use Among Persons Living with HIV Across the US in the Current Era of Antiretroviral Treatment

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