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. 2014 Jul 1:11:16.
doi: 10.1186/1742-6405-11-16. eCollection 2014.

German cohort of HCV mono-infected and HCV/HIV co-infected patients reveals relative under-treatment of co-infected patients

Claudia Beisel  1 , Martin Heuer  1 , Benjamin Otto  1 , Johannes Jochum  1 , Stefan Schmiedel  1 , Sandra Hertling  1 , Olaf Degen  1 , Stefan Lüth  1 , Jan van Lunzen #  1 , Julian Schulze Zur Wiesch #  1
Affiliations

German cohort of HCV mono-infected and HCV/HIV co-infected patients reveals relative under-treatment of co-infected patients

Claudia Beisel et al. AIDS Res Ther. .

Abstract

Background: Current German and European HIV guidelines recommend early evaluation of HCV treatment in all HIV/HCV co-infected patients. However, there are still considerable barriers to initiate HCV therapy in everyday clinical practice. This study evaluates baseline characteristics, "intention-to-treat" pattern and outcome of therapy of HCV/HIV co-infected patients in direct comparison to HCV mono-infected patients in a "real-life" setting.

Methods: A large, single-center cohort of 172 unselected HCV patients seen at the Infectious Diseases Unit at the University Medical Center Hamburg-Eppendorf from 2000-2011, 88 of whom HCV/HIV co-infected, was retrospectively analyzed by chart review with special focus on demographic, clinical and virologic aspects as well as treatment outcome.

Results: Antiviral HCV combination therapy with PEG-interferon plus weight-adapted ribavirin was initiated in 88/172 (52%) patients of the entire cohort and in n = 36 (40%) of all HCV/HIV co-infected patients (group A) compared to n = 52 (61%) of the HCV mono-infected group (group B) (p = 0.006). There were no significant differences of the demographics or severity of the liver disease between the two groups with the exception of slightly higher baseline viral loads in group A. A sustained virologic response (SVR) was observed in 50% (n = 18) of all treated HIV/HCV co-infected patients versus 52% (n = 27) of all treated HCV mono-infected patients (p = 0.859). Genotype 1 was the most frequent genotype in both groups (group A: n = 37, group B: n = 49) and the SVR rates for these patients were only slightly lower in the group of co-infected patients (group A: n = 33%, group B: 40% p = 0.626). During the course of treatment HCV/HIV co-infected patients received less ribavirin than mono-infected patients.

Conclusion: Overall, treatment was only initiated in half of the patients of the entire cohort and in an even smaller proportion of HCV/HIV co-infected patients despite comparable outcome (SVR) and similar baseline characteristics. In the light of newer treatment options, greater efforts to remove the barriers to treatment that still exist for a great proportion of patients especially with HIV/HCV co-infection have to be undertaken.

Keywords: HCV/HIV co-infection; Hepatitis C; PEG interferon/ribavirin treatment.

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Figures

Figure 1
Figure 1
Mode of transmission of hepatitis C Infection.
Figure 2
Figure 2
Enrollment, treatment allocation, and follow-up of study participants.
Figure 3
Figure 3
Hemoglobin levels in g/dl of mono-infected (red) versus co-infected (blue) patients during the course of anti-HCV treatment.
See this image and copyright information in PMC

References

    1. Rosenthal E, Pialoux G, Bernard N, Pradier C, Rey D, Bentata M, Michelet C, Pol S, Perronne C, Cacoub P. Liver-related mortality in human-immunodeficiency-virus-infected patients between 1995 and 2003 in the French GERMIVIC Joint Study Group Network (MORTAVIC 2003 Study) J Viral Hepat. 2007;14:183–188. - PubMed
    1. Bica I, McGovern B, Dhar R, Stone D, McGowan K, Scheib R, Snydman DR. Increasing mortality due to end-stage liver disease in patients with human immunodeficiency virus infection. Clin Infect Dis. 2001;32:492–497. - PubMed
    1. Poynard T, Mathurin P, Lai CL, Guyader D, Poupon R, Tainturier MH, Myers RP, Muntenau M, Ratziu V, Manns M, Vogel A, Capron F, Chedid A, Bedossa P. A comparison of fibrosis progression in chronic liver diseases. J Hepatol. 2003;38:257–265. - PubMed
    1. Berenguer J, Alvarez-Pellicer J, Martin PM, Lopez-Aldeguer J, Von-Wichmann MA, Quereda C, Mallolas J, Sanz J, Tural C, Bellon JM, Gonzalez-Garcia J. Sustained virological response to interferon plus ribavirin reduces liver-related complications and mortality in patients coinfected with human immunodeficiency virus and hepatitis C virus. Hepatology. 2009;50:407–413. - PubMed
    1. Lindh M, Arnholm B, Eilard A, Farkkila M, Hellstrand K, Lagging M, Langeland N, Morch K, Nilsson S, Pedersen C, Buhl MR, Wahlberg T, Wejstal R, Westin J, Norkrans G. Hepatitis C treatment response kinetics and impact of baseline predictors. J Viral Hepat. 2011;18:400–407. - PubMed

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