Clinical Outcomes in Persons Coinfected With Human Immunodeficiency Virus and Hepatitis C Virus: Impact of Hepatitis C Virus Treatment
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Clinical Outcomes in Persons Coinfected With Human Immunodeficiency Virus and Hepatitis C Virus : Impact of Hepatitis C Virus Treatment. / Mocroft, Amanda; Lundgren, Jens; Gerstoft, Jan; Rasmussen, Line D; Bhagani, Sanjay; Aho, Inka; Pradier, Christian; Bogner, Johannes R; Mussini, Christina; Uberti Foppa, Caterina; Maltez, Fernando; Laguno, Montse; Wandeler, Gilles; Falconer, Karolin; Trofimova, Tatyana; Borodulina, Elena; Jevtovic, Djordje; Bakowska, Elzbieta; Kase, Kerstin; Kyselyova, Galina; Haubrich, Richard; Rockstroh, Jürgen K; Peters, Lars; EuroSIDA Study; Losso, M.; Kundro, M.; Schmied, B.; Kronborg, Gitte; Benfield, Thomas; Katzenstein, Terese Lea; Pedersen, C.; Johansen, I. S.; Østergaard, L.; Wiese, L.; Møller, N. F.; Nielsen, L. N.; Scullard, G.; Clarke, A; Leen, C.
In: Clinical Infectious Diseases, Vol. 70, No. 10, 2020, p. 2131-2140.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Clinical Outcomes in Persons Coinfected With Human Immunodeficiency Virus and Hepatitis C Virus
T2 - Impact of Hepatitis C Virus Treatment
AU - Mocroft, Amanda
AU - Lundgren, Jens
AU - Gerstoft, Jan
AU - Rasmussen, Line D
AU - Bhagani, Sanjay
AU - Aho, Inka
AU - Pradier, Christian
AU - Bogner, Johannes R
AU - Mussini, Christina
AU - Uberti Foppa, Caterina
AU - Maltez, Fernando
AU - Laguno, Montse
AU - Wandeler, Gilles
AU - Falconer, Karolin
AU - Trofimova, Tatyana
AU - Borodulina, Elena
AU - Jevtovic, Djordje
AU - Bakowska, Elzbieta
AU - Kase, Kerstin
AU - Kyselyova, Galina
AU - Haubrich, Richard
AU - Rockstroh, Jürgen K
AU - Peters, Lars
AU - EuroSIDA Study
AU - Losso, M.
AU - Kundro, M.
AU - Schmied, B.
AU - Kronborg, Gitte
AU - Benfield, Thomas
AU - Katzenstein, Terese Lea
AU - Pedersen, C.
AU - Johansen, I. S.
AU - Østergaard, L.
AU - Wiese, L.
AU - Møller, N. F.
AU - Nielsen, L. N.
AU - Scullard, G.
AU - Clarke, A
AU - Leen, C.
PY - 2020
Y1 - 2020
N2 - BACKGROUND: A hepatitis C (HCV) cure is associated with changes in lipids and inflammatory biomarkers, but its impact on clinical endpoints among treated human immunodeficiency virus (HIV)/HCV coinfected persons is unclear.METHODS: People living with HIV from EuroSIDA with a known HCV status after January 2001 were classified into strata based on time-updated HCV RNA measurements and HCV treatment, as either HCV antibody-negative; spontaneously resolved HCV; chronic, untreated HCV; cured HCV (HCV RNA-negative); or HCV treatment failures (HCV RNA-positive). Poisson regression was used to compare incidence rates between HCV groups for end-stage liver disease (ESLD; including hepatocellular carcinoma [HCC]), non-acquired immunodeficiency virus defining malignancy (NADM; excluding HCC), and cardiovascular disease (CVD).RESULTS: There were 16 618 persons included (median follow-up 8.3 years, interquartile range 3.1-13.7). There were 887 CVD, 902 NADM, and 436 ESLD events; crude incidence rates/1000 person-years follow-up were 6.4 (95% confidence interval [CI] 6.0-6.9) for CVD, 6.5 (95% CI 6.1-6.9) for NADM, and 3.1 (95% CI 2.8-3.4) for ESLD. After adjustment, there were no differences in incidence rates of NADM or CVD across the 5 groups. HCV-negative individuals (adjusted incidence rate ratio [aIRR] 0.22, 95% CI 0.14-0.34) and those with spontaneous clearance (aIRR 0.61, 95% CI 0.36-1.02) had reduced rates of ESLD compared to cured individuals. Persons with chronic, untreated HCV infections (aIRR 1.47, 95% CI 1.02-2.13) or treatment failure (aIRR 1.80, 95% CI 1.22-2.66) had significantly raised rates of ESLD, compared to those who were cured.CONCLUSIONS: Incidences of NADM or CVD were independent of HCV group, whereas those cured had substantially lower incidences of ESLD, underlining the importance of successful HCV treatment for reducing ESLD.
AB - BACKGROUND: A hepatitis C (HCV) cure is associated with changes in lipids and inflammatory biomarkers, but its impact on clinical endpoints among treated human immunodeficiency virus (HIV)/HCV coinfected persons is unclear.METHODS: People living with HIV from EuroSIDA with a known HCV status after January 2001 were classified into strata based on time-updated HCV RNA measurements and HCV treatment, as either HCV antibody-negative; spontaneously resolved HCV; chronic, untreated HCV; cured HCV (HCV RNA-negative); or HCV treatment failures (HCV RNA-positive). Poisson regression was used to compare incidence rates between HCV groups for end-stage liver disease (ESLD; including hepatocellular carcinoma [HCC]), non-acquired immunodeficiency virus defining malignancy (NADM; excluding HCC), and cardiovascular disease (CVD).RESULTS: There were 16 618 persons included (median follow-up 8.3 years, interquartile range 3.1-13.7). There were 887 CVD, 902 NADM, and 436 ESLD events; crude incidence rates/1000 person-years follow-up were 6.4 (95% confidence interval [CI] 6.0-6.9) for CVD, 6.5 (95% CI 6.1-6.9) for NADM, and 3.1 (95% CI 2.8-3.4) for ESLD. After adjustment, there were no differences in incidence rates of NADM or CVD across the 5 groups. HCV-negative individuals (adjusted incidence rate ratio [aIRR] 0.22, 95% CI 0.14-0.34) and those with spontaneous clearance (aIRR 0.61, 95% CI 0.36-1.02) had reduced rates of ESLD compared to cured individuals. Persons with chronic, untreated HCV infections (aIRR 1.47, 95% CI 1.02-2.13) or treatment failure (aIRR 1.80, 95% CI 1.22-2.66) had significantly raised rates of ESLD, compared to those who were cured.CONCLUSIONS: Incidences of NADM or CVD were independent of HCV group, whereas those cured had substantially lower incidences of ESLD, underlining the importance of successful HCV treatment for reducing ESLD.
U2 - 10.1093/cid/ciz601
DO - 10.1093/cid/ciz601
M3 - Journal article
C2 - 31504296
VL - 70
SP - 2131
EP - 2140
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
SN - 1058-4838
IS - 10
ER -
ID: 237653551