HIV Coinfection With Hepatitis C Virus: Evolving Epidemiology and Treatment Paradigms

Taylor, Lynn E.; Swan, Tracy; Mayer, Kenneth H.

doi:10.1093/cid/cis367

Cited by 140 publications

(136 citation statements)

References 66 publications

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“…Moreover, the spontaneous elimination of HCV is also decreased in untreated HIV coinfected patients [2]. One of the leading causes of death in HIV treated coinfected patients is chronic HCV infection [3], due to drug-related hepatoxicity. On the other hand, there is evidence that treatment of HIV can slow the natural progression of HCV infection and reduce HCV mortality related to liver diseases [1].…”

Section: Introductionmentioning

confidence: 99%

HIV/HCV coinfection model: a fractional-order perspective for the effect of the HIV viral load

2018

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We study the burden of the HIV viremia and of treatment efficacy in the severity of the patterns of the HIV/HCV coinfection. For this, we derive a simple non-integer-order (fractional-order) model for the coinfection dynamics. Fractional-order models have been proved in the literature to provide good fits to real data from patients suffering from several diseases, such as HIV, dengue fever, and others. We have computed the basic reproduction number and the stability of the disease-free equilibrium of the model. The numerical results suggest that the HIV viral load impacts impressively the severity of the HCV infection. The treatment efficacy is also found to influence the natural progression of HCV on the HIV/HCV coinfection. The latter is repeated for all values of the order of the fractional derivative. Moreover, the fractional derivative may pave the way to better understanding the individuals' patients' adjustments to treatment and to viremia.

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Section: Introductionmentioning

confidence: 99%

HIV/HCV coinfection model: a fractional-order perspective for the effect of the HIV viral load

2018

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“…It is estimated that 30% of patients in the United States infected with HIV are coinfected with chronic hepatitis C virus (HCV) (13). Although it is speculated that HCV may be a risk factor for the development of PH (independent of HIV and/or portopulmonary hypertension), this has not been well studied (6).…”

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confidence: 99%

Risk of Echocardiographic Pulmonary Hypertension in Individuals with Human Immunodeficiency Virus–Hepatitis C Virus Coinfection

et al. 2014

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Rationale: Human immunodeficiency virus (HIV) infection is a risk factor for pulmonary hypertension (PH). Chronic hepatitis C virus (HCV) infection may have unique or synergistic effects on the pulmonary vasculature, but the prevalence and risk factors for PH in HIV-HCV coinfected persons are not known.Objectives: To define the prevalence of echocardiographic PH in a cohort of patients with HIV-HCV coinfection, to compare this estimate with the reported prevalence of PH among those with HIV infection alone, and to identify potential risk factors for PH in coinfected individuals.Methods: We performed a retrospective study of HIV-HCV coinfected patients followed at our institution from 2003 to 2012 with evidence of HCV infection (positive HCV antibody, measurable HCV ribonucleic acid viral load, and/or genotype) within 6 months of transthoracic echocardiogram. PH was defined by an estimated pulmonary artery systolic pressure (PASP) of greater than or equal to 40 mm Hg or more than moderate right ventricular dysfunction. We excluded those diagnosed with cirrhosis, left ventricular ejection fraction less than 50%, or more than moderate aortic or mitral valve disease. Measurements and Main Results:Sixty-eight patients were included, and 43 had adequate estimates of PASP. The median (interquartile range) age was 52 (48-57) years, and 45 (67%) were men. Eight (19%) had PH, and three (7%) had more than moderate right ventricular dysfunction. After age and sex adjustment, interferon (IFN)-based HCV treatment was associated with higher PASP (b, 6.00 mm Hg; 95% confidence interval, 0.09-11.90; P = 0.047) and with the risk of PH (odds ratio, 5.65; 95% confidence interval, 1.07-29.93; P = 0.042). These associations persisted after adjustment for comorbidities but were attenuated by adjustment for duration of HCV diagnosis. Conclusions:The prevalence of echocardiographic PH may be higher in HIV-HCV coinfected individuals than in those with HIV monoinfection. IFN-based HCV treatment and time since HCV diagnosis were associated with the development of PH as assessed by echocardiography. Further studies are needed to examine HIV-HCV coinfection, HCV treatment, and duration of infection as possible causes of pulmonary vascular disease.

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“…[7][8][9][10] Risk groups include injection drug users, recipients of infected blood products, children of HCVpositive mothers, and human immunodeficiency virus (HIV)−infected persons. [11][12][13][14] Past drug users or recipients of blood transfusions will remain hidden, however, as they may not remember or report these behaviors. 15 To capture all persons who have HCV infection, prospective studies are needed that evaluate the diagnostic yield of HCV testing strategies not based on exposure risk factors.…”

Section: Introductionmentioning

confidence: 99%

Detecting Hepatitis B and C by Combined Public Health and Primary Care Birth Cohort Testing

et al. 2018

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PURPOSE Both chronic hepatitis C (HCV) and B virus (HBV) infections are generally asymptomatic, and many remain undetected or are diagnosed at a late stage. Studies that evaluate best practice hepatitis testing strategies are needed to better detect this hidden population. METHODSIn this prospective cohort study, we aimed to determine the diagnostic yield (test uptake and rate of positive test results) of a combined public health and primary care birth cohort testing strategy in detecting hidden cases of HCV and HBV infections. We invited all patients aged between 40 and 70 years (n = 6,743) registered with 11 family practices serving 2 higher prevalence areas, or hotspots (ie, estimated HCV prevalence of 1%; national estimated prevalence is 0.1-0.4%), in the south of the Netherlands. RESULTSTest uptake was 50.9% (n = 3,434 patients). No active or chronic HCV infection was detected: 0.00% (95% CI, 0.00%-0.11%). Positive test rates were 0.20% (95% CI, 0.08%-0.42%) for anti-HCV (n = 7), 0.26% (95% CI, 0.12%-0.50%) for hepatitis B surface antigen (n = 9), and 4.14% (95% CI, 3.49%-4.86%) for antihepatitis B core (n = 142).CONCLUSIONS This best practice testing strategy was effective in achieving a high test uptake. It completely failed, however, to detect hidden chronic HCV infections and is not recommended for countries with a low prevalence of the disease.

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HIV Coinfection With Hepatitis C Virus: Evolving Epidemiology and Treatment Paradigms

Cited by 140 publications

References 66 publications

HIV/HCV coinfection model: a fractional-order perspective for the effect of the HIV viral load

HIV/HCV coinfection model: a fractional-order perspective for the effect of the HIV viral load

Risk of Echocardiographic Pulmonary Hypertension in Individuals with Human Immunodeficiency Virus–Hepatitis C Virus Coinfection

Detecting Hepatitis B and C by Combined Public Health and Primary Care Birth Cohort Testing

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