Retrospective analysis of the impact of HIV infection and alcohol use on chronic hepatitis C in a large cohort of drug users

Pol, Stanislas; B, Lamorthe; Thi, Ngoc Trinh; Thiers, Valérie; Carnot, Françoise; Zylberberg, Hervé; Berthelot, Pièrre; Bréchot, Christian; Nalpas, Bertrand

doi:10.1016/s0168-8278(98)80341-3

Cited by 157 publications

(80 citation statements)

References 30 publications

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“…Another retrospective study identified both alcohol and HIV to have a deleterious effect on chronic hepatitis C in drug users but failed to find an additive deleterious effect of alcohol in HIV-positive patients. 3 In our study, the deleterious effect of alcohol on the course of HCV-related liver disease was independent of HIV status, consistent with that seen in HIV-negative patients. 15,16 Moreover, a relationship between alcohol and serum HCV-RNA level was observed in our study, as well as previously reported in HIV-negative patients.…”

Section: Discussionsupporting

confidence: 88%

“…It shows also a significant effect of HIV infection on HCV-RNA levels, biochemical liver tests, liver histologic necroinflammatory lesions, and biochemical responses to interferon therapy. This negative influence of HIV on the course of chronic hepatitis C has already been reported in injection drug users in some studies, 2,3,19 but not in all. 7,8 However, our study provides stronger evidence than previous studies for the following reasons: it provides a long-term follow-up with histologic assessment of a relatively large number of patients, matched for the main prognostic factors (age, duration of HCV infection, gender) and includes multivariate analysis including excessive alcohol consumption, that is common in such a population.…”

Section: Discussionmentioning

confidence: 60%

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The influence of human immunodeficiency virus coinfection on chronic hepatitis C in injection drug users: A long-term retrospective cohort study

et al. 2001

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In this study we analyzed the influence of human immunodeficiency virus (HIV) infection on the course of chronic hepatitis C through multivariate analysis including age, alcohol consumption, immune status, and hepatitis C virus (HCV)-related virologic factors. Eighty HIV-positive and 80 HIV-negative injection drug users included between 1980 and 1995 were matched according to age, gender, and duration of HCV infection and followed-up during 52 months. The progression to cirrhosis was the primary outcome measure. The impact of HIV on HCV-RNA load, histologic activity index, response to interferon therapy, and liver-related death was also considered. In HIV-positive patients, chronic hepatitis C was characterized by higher serum HCV-RNA levels (P ‫؍‬ .012), higher total Knodell score (P ‫؍‬ .011), and poorer sustained response to interferon therapy (P ‫؍‬ .009). High serum HCV-RNA level was associated with low CD4-lymphocyte count (P ‫؍‬ .001). Necroinflamatory score was higher in HIV-positive patients (P ‫؍‬ .023) independently of the CD4-lymphocyte count, whereas increased fibrosis was related to decreased CD4-lymphocyte count (P ‫؍‬ .011). The progression to cirrhosis was accelerated in HIV-positive patients with low CD4 cell count (RR ‫؍‬ 4.06, P ‫؍‬ .024) and in interferon-untreated patients (RR ‫؍‬ 4.76, P ‫؍‬ .001), independently of age at HCV infection (P ‫؍‬ .001). Cirrhosis caused death in 5 HIV-positive patients. The risk of death related to cirrhosis was increased in heavy drinkers (RR ‫؍‬ 10.8, P ‫؍‬ .001) and in HIV-positive patients with CD4 cell count less than 200/mm 3 (RR ‫؍‬ 11.9, P ‫؍‬ .007). In this retrospective cohort study, HIV coinfection worsened the outcome of chronic hepatitis C, increasing both serum HCV-

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 60%

The influence of human immunodeficiency virus coinfection on chronic hepatitis C in injection drug users: A long-term retrospective cohort study

et al. 2001

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“…83,100,101 Studies have shown that chronic hepatitis C patients with HIV infection have a worse prognosis as compared to those without HIV. [102][103][104][105][106][107] Coinfection with HIV and HCV is associated with a lower rate of spontaneous HCV RNA clearance. 108 There is an increased rate of fibrosis in HIV and HCV coinfected patients, with an accelerated progression of HCV-related liver disease.…”

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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“…Of them, 6242 were positive for HIV and 10508 were negative for HIV. Fourteen studies assessed the histological cirrhosis [9,18,19,21,[27][28][29][30][31][32]38,39,41,42] , 7 studies assessed the death [17,22,23,[34][35][36]40] , 3 studies assessed the decompensated liver disease [15,26,37] , 2 studies assessed the outcome of decompensated liver disease and death [16][17][18][19][20][21][22][23][24][25] , 1 study assessed the outcome of histological cirrhosis, hepatocellular carcinoma and death [20] , 1 study assessed the outcome of histological cirrhosis and death [24] , and 1 study assessed the outcome of hepatocellular carcinoma and death [33] , respectively. Most studies did not provide a racial distribution.…”

Section: Deng Lp Et Al Impact Of Hiv Infection On Hcv Infectionmentioning

confidence: 99%

Impact of human immunodeficiency virus infection on the course of hepatitis C virus infection: A meta-analysis

Deng¹,

Gui²,

Zhang³

et al. 2009

WJG

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AIM:To analyze the influence of human immunodeficiency virus (HIV) infection on the course of hepatitis C virus (HCV) infection. METHODS:We performed a meta-analysis to quantify the effect of HIV co-infection on progressive liver disease in patients with HCV infection. Published studies in the English or Chinese-language medical literature involving cohorts of HIV-negative and -positive patients coinfected with HCV were obtained by searching the PUBMED, EMBASE and CBM. Data were extracted independently from relevant studies by 2 investigators and used in a fixed-effect meta analysis to determine the difference in the course of HCV infection in the 2 groups. RESULTS:Twenty-nine trails involving 16 750 patients were identified including the outcome of histological fibrosis or cirrhosis or de-compensated liver disease or hepatocellular carcinoma or death. These studies yielded a combined adjusted odds ratio (OR) of 3.40 [95% confidence interval (CI) = 2.45 and 4.73]. Of note, studies that examined histological fibrosis/ cirrhosis, decompensated liver disease, hepatocellular carcinoma or death had a pooled OR of 1.47 (95% CI = 1.27 and 1.70), 5.45 (95% CI = 2.54 and 11.71), 0.76 (95% CI = 0.50 and 1.14), and 3.60 (95% CI = 3.12 and 4.15), respectively. CONCLUSION:Without highly active antiretroviral therapies (HAART), HIV accelerates HCV disease progression, including death, histological fibrosis/ cirrhosis and decompensated liver disease. However, the rate of hepatocellular carcinoma is similar in persons who had HCV infection and were positive for HIV or negative for HIV.

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Retrospective analysis of the impact of HIV infection and alcohol use on chronic hepatitis C in a large cohort of drug users

Cited by 157 publications

References 30 publications

The influence of human immunodeficiency virus coinfection on chronic hepatitis C in injection drug users: A long-term retrospective cohort study

The influence of human immunodeficiency virus coinfection on chronic hepatitis C in injection drug users: A long-term retrospective cohort study

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

Impact of human immunodeficiency virus infection on the course of hepatitis C virus infection: A meta-analysis

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