Efficacy and safety of direct-acting antiviral regimens in HIV/HCV-co-infected patients – French ANRS CO13 HEPAVIH cohort

Piroth, Lionel; Wittkop, Linda; Lacombe, Karine; Rosenthal, Éric; Gilbert, Camille; Miailhes, Patrick; Carrieri, Patrizia; Chas, Julie; Poizot‐Martin, Isabelle; Gervais, Anne; Dominguez, Stéphanie; Néau, Didier; Zucman, David; Billaud, Éric; Morlat, Philippe; Aumaître, Hugues; Lascoux-Combe, Caroline; Simon, Anne; Bouchaud, Olivier; Teicher, Elina; Bani‐Sadr, Firouzé; Alric, Laurent; Vittecoq, D.; Boué, François; Duvivier, Claudine; Valantin, Marc‐Antoine; Esterle, Laure; Dabis, François; Sogni, Philippe; Salmon, Dominique

doi:10.1016/j.jhep.2017.02.012

Cited by 44 publications

(39 citation statements)

References 26 publications

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“…This reinforces the message to treat all HIV/HCV co‐infected patients for their hepatitis as for HCV mono‐infected patients, especially given that there are no more differences in the response rate to new DAAs between both populations, with a rate of SVR reaching 93%‐95% in clinical trials as in real‐life studies whatever the combinations of DAAs used . Moreover, eradication of HCV infection in patients with cirrhosis has been shown to reduce the risk of HCC, decompensation, and nonliver complications such as cardiovascular events and bacterial infections .…”

Section: Discussionsupporting

confidence: 53%

Human Immunodeficiency Virus/Hepatitis C Virus (HCV) Co‐infected Patients With Cirrhosis Are No Longer at Higher Risk for Hepatocellular Carcinoma or End‐Stage Liver Disease as Compared to HCV Mono‐infected Patients

et al. 2019

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It is widely accepted that human immunodeficiency virus (HIV) infection is a risk factor for increased severity of hepatitis C virus (HCV) liver disease. However, owing to better efficacy and safety of combination antiretroviral therapy (cART), and increased access to HCV therapy, whether this condition remains true is still unknown. Overall, 1,253 HCV mono‐infected patients and 175 HIV/HCV co‐infected patients with cirrhosis, included in two prospective French national cohorts (ANRS CO12 CirVir and CO13 HEPAVIH), were studied. Cirrhosis was compensated (Child‐Pugh A), without past history of complication, and assessed on liver biopsy. Incidences of liver decompensation (LD), hepatocellular carcinoma (HCC), and death according to HIV status were calculated by a Fine‐Gray model adjusted for age. Propensity score matching was also performed to minimize confounding by baseline characteristics. At baseline, HIV/HCV patients were younger (47.5 vs. 56.0 years; P < 0.001), more frequently males (77.1% vs. 62.3%; P < 0.001), and had at baseline and at end of follow‐up similar rates of HCV eradication than HCV mono‐infected patients. A total of 80.4% of HIV/HCV patients had an undetectable HIV viral load. After adjustment for age, 5‐year cumulative incidences of HCC and decompensation were similar in HIV/HCV and HCV patients (8.5% vs. 13.2%, P = 0.12 and 12.8% vs. 15.6%, P = 0.40, respectively). Overall mortality adjusted for age was higher in HIV/HCV co‐infected patients (subhazard ratio [SHR] = 1.88; 95% confidence interval [CI], 1.15‐3.06; P = 0.011). Factors associated with LD and HCC were age, absence of sustained virological response, and severity of cirrhosis, but not HIV status. Using a propensity score matching 95 patients of each group according to baseline features, similar results were observed. Conclusion: In HCV‐infected patients with cirrhosis, HIV co‐infection was no longer associated with higher risks of HCC and hepatic decompensation. Increased mortality, however, persisted, attributed to extrahepatic conditions.

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Section: Discussionsupporting

confidence: 53%

Human Immunodeficiency Virus/Hepatitis C Virus (HCV) Co‐infected Patients With Cirrhosis Are No Longer at Higher Risk for Hepatocellular Carcinoma or End‐Stage Liver Disease as Compared to HCV Mono‐infected Patients

et al. 2019

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“…In a French HCV/HIV cohort, an overall SVR rate of 93% was reported with no difference among those with cirrhosis. (78) Similarly high real-world rates of SVR have been described elsewhere, making drug interactions the main clinical issue with HCV treatment.…”

Section: Management Of Hcv/hivmentioning

confidence: 64%

Human immunodeficiency virus and liver disease: A comprehensive update

Sherman

Peters

Thomas

2017

Hepatology Communications

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Among persons living with human immunodeficiency virus (HIV) infection, liver disease remains a major cause of morbidity and mortality. While the etiologies are varied and often overlapping in the individual patient, the underlying mechanisms, including oxidative stress, direct activation of stellate cells, HIV interaction with hepatocytes, and bacterial translocation with systemic immune activation, seem to be unifying characteristics. Early and fully suppressive HIV antiretroviral therapy is a mainstay of management either before or concurrent with treatment of etiologic cofactors, including hepatitis C virus, hepatitis B virus, and nonalcoholic fatty liver disease/nonalcoholic steatohepatitis. Significant barriers to care that still exist include liver disease recognition, appropriate linkage to care, ongoing substance abuse, and psychiatric comorbidities in the HIV‐infected population. Emerging issues in these patients include acute and chronic hepatitis E, underreported hepatitis D, and a rising incidence of hepatocellular carcinoma. (Hepatology Communications 2017;1:987–1001)

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“…Several studies have shown that HCV clearance by DAA treatments improves IR in patients with mild liver fibrosis but not in patients with advanced liver fibrosis . Therefore, prospective studies should be conducted to assess the impact of early treatment of HCV infection, and of high rates of SVR with DAA treatments, on the occurrence of DM …”

Section: Discussionmentioning

confidence: 99%

Risk of diabetes in HIV‐infected patients is associated with cirrhosis but not with chronic HCV coinfection in a French nationwide HIV cohort

Provoost¹,

Dramé²,

Cotte³

et al. 2018

Aliment Pharmacol Ther

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Efficacy and safety of direct-acting antiviral regimens in HIV/HCV-co-infected patients – French ANRS CO13 HEPAVIH cohort

Cited by 44 publications

References 26 publications

Human Immunodeficiency Virus/Hepatitis C Virus (HCV) Co‐infected Patients With Cirrhosis Are No Longer at Higher Risk for Hepatocellular Carcinoma or End‐Stage Liver Disease as Compared to HCV Mono‐infected Patients

Human Immunodeficiency Virus/Hepatitis C Virus (HCV) Co‐infected Patients With Cirrhosis Are No Longer at Higher Risk for Hepatocellular Carcinoma or End‐Stage Liver Disease as Compared to HCV Mono‐infected Patients

Human immunodeficiency virus and liver disease: A comprehensive update

Risk of diabetes in HIV‐infected patients is associated with cirrhosis but not with chronic HCV coinfection in a French nationwide HIV cohort

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