Coinfection of hepatitis B and hepatitis C virus in HIV-infected patients in south India

Saravanan, S.; Vijayakumar, V.; Kumarasamy, Nagalingeswaran; Nandakumar, Subhadra; Murugavel, Kailapuri G.; Balakrishnan, Pachamuthu; Solomon, Suniti; Thyagarajan, Sadras Panchatcharam

doi:10.3748/wjg.v13.i37.5015

Cited by 91 publications

(97 citation statements)

References 26 publications

(2 reference statements)

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“…[88][89][90][91][92][93] A high prevalence of HCV and HIV coinfection has been found in intravenous drug users ranging from 13.2% to 86%. [94][95][96][97] HIV-infected patients with HCV coinfection have a faster progression to AIDS and slower CD4+ recovery than patients with HIV infection alone as was shown in the Swiss Cohort study.…”

Section: Management Of Hcv In Hiv Coinfectionmentioning

confidence: 99%

Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

Puri

Saraswat

Dhiman

et al. 2016

Journal of Clinical and Experimental Hepatology

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India contributes significantly to the global burden of HCV. While the nucleoside NS5B inhibitor sofosbuvir became available in the Indian market in March 2015, the other directly acting agents (DAAs), Ledipasvir and Daclatasvir, have only recently become available in the India. The introduction of these DAA in India at a relatively affordable price has led to great optimism about prospects of cure for these patients as not only will they provide higher efficacy, but combination DAAs as all-oral regimen will result in lower side effects than were seen with pegylated interferon alfa and ribavirin therapy. Availability of these newer DAAs has necessitated revision of INASL guidelines for the treatment of HCV published in 2015. Current considerations for the treatment of HCV in India include the poorer response of genotype 3, nonavailability of many of the DAAs recommended by other guidelines and the cost of therapy. The availability of combination DAA therapy has simplified therapy of HCV with decreased reliance of evaluation for monitoring viral kinetics or drug related side effects. ( J CLIN EXP HEPATOL 2016;6:119-145) T here have been revolutionary changes in the management of chronic hepatitis C (CH-C) over the last few years. Pegylated interferon alfa (Peg-IFNa) plus ribavirin (RBV) therapy, which till the recent past was the standard of care, has been eclipsed by the arrival of newer directly acting antiviral agents (DAAs). Not only do the DAAs have better efficacy, they are also associated with lower side effects, have better tolerability, a shorter duration of therapy, and have simpler administration.In the recent guidelines issued by the American Association for the study of Liver Diseases (AASLD), in collaboration with the Infectious Diseases Society of America 1 and the European Association for Study of the Liver z (EASL), 2 the role of Peg-IFNa/RBV therapy in the management of HCV has been relegated to second-line, backup status. These newer guidelines, however, cannot be implemented in India as many of the recommended drugs are yet to be marketed in India. Other considerations for the treatment of HCV in India are a predominance of

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Section: Management Of Hcv In Hiv Coinfectionmentioning

confidence: 99%

Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

Puri

Saraswat

Dhiman

et al. 2016

Journal of Clinical and Experimental Hepatology

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“…In southern India, prevalence of HCV infection among HIV-infected persons is higher than that in northern India. [107][108][109][110][111][112] HCV-HIV co-infection is commoner in patients with low CD4 counts (<200/mL) 109 …”

Section: Hiv Infectionmentioning

confidence: 99%

“…144 Studies from northern, eastern and western India have uniformly shown predominance of genotype 3; however, in southern India, both genotype 1 and 3 HCV are prevalent. 110,145 Genotype 4 HCV has been identified in some cases from southern and western India. 139,141,146 Genotype 6 HCV infection has been reported from eastern and northeastern parts of India.…”

Section: Genotypes Distribution Of Hcv In Indiamentioning

confidence: 99%

“…There is a need for large field studies to better understand HCV epidemiology and identify high-prevalence areas, and to identify and spread awareness about the modes of transmission of this infection in an attempt to prevent disease transmission. ( J CLIN EXP HEPATOL 2014;4: [106][107][108][109][110][111][112][113][114][115][116] understand the risk factors associated with transmission of this infection. This would also allow appropriate choice and targeting of efforts to prevent the spread of this disease, and thereby reduce the burden of chronic liver disease in the country.…”

mentioning

confidence: 99%

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Consensus Statement of HCV Task Force of the Indian National Association for Study of the Liver (INASL). Part I: Status Report of HCV Infection in India

Puri

Anand

Saraswat

et al. 2014

Journal of Clinical and Experimental Hepatology

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Globally, around 150 million people are infected with hepatitis C virus (HCV). India contributes a large proportion of this HCV burden. The prevalence of HCV infection in India is estimated at between 0.5% and 1.5%. It is higher in the northeastern part, tribal populations and Punjab, areas which may represent HCV hotspots, and is lower in western and eastern parts of the country. The predominant modes of HCV transmission in India are blood transfusion and unsafe therapeutic injections. There is a need for large field studies to better understand HCV epidemiology and identify high-prevalence areas, and to identify and spread awareness about the modes of transmission of this infection in an attempt to prevent disease transmission. ( J CLIN EXP HEPATOL 2014;4:106-116)

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“…17,18 Although the prevalence of HBV-HIV co-infection in India varies from 9% to as high as 30%, there is no published study describing experiences and treatment outcomes among such patients in India. [19][20][21][22][23] The aim of the present study was to report on treatment and laboratory outcomes among HBV/HIV co-infected individuals who received TDF/lamivudine as a part of an antiretroviral regimen, in an urban, resource-limited setting in Mumbai, India.…”

Section: Introductionmentioning

confidence: 99%

Treatment outcomes in a cohort of patients with chronic hepatitis B and human immunodeficiency virus co-infection in Mumbai, India

Isaakidis¹,

Mansoor²,

Zachariah³

et al. 2012

International Health

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CitationTreatment outcomes in a cohort of patients with chronic hepatitis B and human immunodeficiency virus coinfection in Mumbai, India 2012, 4 (4) Treatment experiences with patients co-infected with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) in resource-limited settings remain poorly documented.This study aimed to evaluate the treatment outcomes in a cohort of HIV/HBV co-infected individuals receiving tenofovir/lamivudine (TDF/3TC)-based antiretroviral therapy (ART) in a programmatic setting in Mumbai, India. Additionally, a cross-sectional laboratory study was carried out measuring serologic and virologic parameters. A total of 57 patients who received TDF/3TC were included in the study. Of these, 52 (91%) were male and the mean age was 38.7 years. The median follow-up period was 16.8 months (IQR:7.9-37.9). Forty-three patients were included in the cross-sectional laboratory study, of whom 38 (67%) were HBeAg + positive. Four patients had serum HBsAg conversion to negative and had developed anti-HBs-antibodies. HBV-DNA became undetectable (<1.3 log 10 copies/ml or <20 IU/ml) in 35.5% and 75% of the HBeAg + and HBeAg − patients, respectively. Overall, 46.5% of patients had undetectable HBV-DNA and 90.7% had adequately suppressed HBV-DNA (<3.3 log 10 copies/ml or <2000 IU/ml). The median reduction in serum HBV-DNA was 6 log 10 copies/ml. In 29 patients (63%) HIV viral load was undetectable. Outcomes included seven (12%) deaths, four (7%) lost to follow-up, one (2%) transferred out and 45 (79%) alive and on treatment. In conclusion, good treatment outcomes were achieved in a cohort of HIV/HBV co-infected patients in India. In regions with a high HIV/HBV burden, all HIV-infected individuals should be tested for chronic hepatitis B. A TDF/3TC-backbone could be considered as first-line standardized ART regimen in these settings.

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Coinfection of hepatitis B and hepatitis C virus in HIV-infected patients in south India

Cited by 91 publications

References 26 publications

Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

Consensus Statement of HCV Task Force of the Indian National Association for Study of the Liver (INASL). Part I: Status Report of HCV Infection in India

Treatment outcomes in a cohort of patients with chronic hepatitis B and human immunodeficiency virus co-infection in Mumbai, India

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