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

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http://journals.lww.com/eurojgh/Abstract/2011/01000/Hepatitis_C_virus_treatment_\

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European Journal of Gastroenterology & Hepatology:

January 2011 - Volume 23 - Issue 1 - p 45–50

doi: 10.1097/MEG.0b013e328341ef54

Original Articles: Hepatitis

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

co-infected individuals at an urban HIV clinic

Murray, C.M.a; Barrios, Rolandoc; Zhang, c; Hull, Marka,c,d;

Montessori, Valentinaa,c; Hogg, S.c,d; Montaner, Julio S.G.b,c

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.

© 2011 Lippincott & Wilkins, Inc.