Hepatitis C virus treatment rates and outcomes in HIV/hepatitis C virus co-infected individuals at an urban HIV clinic

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Eur J Gastroenterol Hepatol. 2011 Jan;23(1):45-50.

Hepatitis C virus treatment rates and outcomes in HIV/hepatitis C virus

co-infected individuals at an urban HIV clinic.

Murray MC, Barrios R, Zhang W, Hull M, Montessori V, Hogg RS, Montaner JS.

aDivision of Infectious Disease bDivision of AIDS, Department of Medicine,

University of British Columbia cBritish Columbia Centre for Excellence in

HIV/AIDS, Providence Health Care dFaculty of Health Sciences, Simon Fraser

University, Vancouver, Canada.

Abstract

OBJECTIVES: The factors associated with hepatitis C virus (HCV) treatment uptake

and responses were assessed among HCV/HIV co-infected individuals referred for

HCV therapy at an urban HIV clinic.

METHODS: Retrospective review of HIV/HCV patients enrolled in the HCV treatment

program at the Ruedy Immunodeficiency Clinic in Vancouver. The factors

associated with treatment uptake were assessed using multivariate analysis.

RESULTS: A total of 134 HCV/HIV co-infected individuals were recalled for

assessment for HCV therapy. Overall 64 (48%) initiated treatment, and of those

treated 49 (76.6%) attained end treatment response, whereas 35 (57.8%) achieved

sustained virological response (SVR). When evaluated by genotype, 53% (17/32) of

those with genotype 1, and 65% (20/31) of those with genotype 2 or 3 infections

attained SVR. In treated individuals, alanine aminotransferase dropped

significantly after treatment (P<0.001). During treatment, CD4 counts dropped

significantly (P<0.001) in all patients. The counts recovered to baseline in

patients who achieved SVR, but remained lower in patients who failed the therapy

(P=0.015). On multivariate analysis, history of injection drug use (odds ratio:

3.48; 95% confidence interval: 1.37-8.79; P=0.009) and low hemoglobin levels

(odds ratio: 4.23; 95% confidence interval: 1.36-13.10; P=0.013) were associated

with those who did not enter the treatment.

CONCLUSION: Only half of treatment-eligible co-infected patients referred for

the therapy initiated treatment. Of those referred for the therapy, history of

injection drug use was associated with lower rates of treatment uptake. Treated

HIV/HCV co-infected individuals benefitted from both decreased alanine

aminotransferase (independent of SVR), and rates of SVR similar to those

described in HCV monoinfected patients.

PMID: 21139470 [PubMed - in process]