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Bazmjoo A, Bagherzadeh MA, Raoofi R, Taghipour A, Mazaherifar S, Sotoodeh H, Ostadi Z, Shadmand E, Jahromi MAM, Abdoli A. Toxoplasma gondii, HBV, and HCV co-infection and their correlation with CD4 cells among Iranian HIV-positive patients. Immun Inflamm Dis 2023; 11:e794. [PMID: 36840494 PMCID: PMC9947625 DOI: 10.1002/iid3.794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 02/01/2023] [Accepted: 02/09/2023] [Indexed: 02/25/2023] Open
Abstract
INTRODUCTION Human immunodeficiency virus (HIV/AIDS) infected patients have a higher risk of opportunistic infections (OIs) depending on their immunological status, especially CD4 + cell count. Toxoplasma gondii, hepatitis C virus (HCV), and hepatitis B virus (HBV) are important OIs among Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) patients. However, little is known about co-infection of these pathogens among HIV-infected individuals and their correlation with the patient's CD4 + cell count. Hence, this study aimed to investigate the serological and molecular status of T. gondii infection among HIV-infected individuals who had co-infection with HBV and HCV infections. METHODS A total of 100 HIV/AIDS patients in two cities in the southwest of Iran was tested for T. gondii Immunoglobulin G (IgG) and Immunoglobulin M (IgM) antibodies as well as DNA detection by polymerase chain reaction (PCR) targeting the RE gene. HBV and HCV were detected by hepatitis B surface antigen (HBsAg) test, hepatitis C antibody (HCV Ab) test, and Real-Time PCR. The number of CD4 + cell counts was determined by Flow cytometry. RESULTS Anti-T. gondii IgG was positive in 22% of the patients, but anti-T. gondii IgM and PCR were negative in all samples. HBV and HCV were positive in 8% and 33% of the patients, respectively. Co-infections were as followed: HIV + HCV (16%), HIV + HCV + T. gondii (11%), HIV + T. gondii (5%), HIV + HBV (1%), HIV + HBV + T. gondii (1%), HIV + HBV + HCV (1%), and HIV + HBV + HCV + T. gondii (5%). A significant decline in CD4 + cell counts was found in such co-infection groups (HIV + T. gondii, HIV + HCV + T. gondii, and HIV + HBV + HCV + T. gondii) compared with the HIV mono-infection group. CONCLUSIONS Our study showed that co-infections of T. gondii, HCV, and HBV were common among HIV-infected patients and co-infections had a negative correlation with CD4 + cell counts of the patients.
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Affiliation(s)
- Ahmadreza Bazmjoo
- Zoonoses Research CenterJahrom University of Medical SciencesJahromIran,Student Research CommitteeJahrom University of Medical SciencesJahromIran
| | - Mohammad Aref Bagherzadeh
- Zoonoses Research CenterJahrom University of Medical SciencesJahromIran,Student Research CommitteeJahrom University of Medical SciencesJahromIran
| | - Rahim Raoofi
- Zoonoses Research CenterJahrom University of Medical SciencesJahromIran,Department of Infectious DiseasesJahrom University of Medical SciencesJahromIran
| | - Ali Taghipour
- Zoonoses Research CenterJahrom University of Medical SciencesJahromIran,Department of Parasitology and MycologyJahrom University of Medical SciencesJahromIran
| | - Samaneh Mazaherifar
- Zoonoses Research CenterJahrom University of Medical SciencesJahromIran,Department of Parasitology and MycologyJahrom University of Medical SciencesJahromIran
| | | | - Zahra Ostadi
- Department of Disease ControlFasa University of Medical SciencesFasaIran
| | - Enayat Shadmand
- Zoonoses Research CenterJahrom University of Medical SciencesJahromIran,Department of Parasitology and MycologyJahrom University of Medical SciencesJahromIran
| | - Mirza A. M. Jahromi
- Zoonoses Research CenterJahrom University of Medical SciencesJahromIran,Department of ImmunologyJahrom University of Medical SciencesJahromIran,Department of Advanced Medical Sciences & TechnologiesJahrom University of Medical SciencesJahromIran
| | - Amir Abdoli
- Zoonoses Research CenterJahrom University of Medical SciencesJahromIran,Department of Parasitology and MycologyJahrom University of Medical SciencesJahromIran
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Yin X, Kong L, Du P, Jung J. Effects of direct-acting antiviral treatment on reducing mortality among Medicare beneficiaries with HIV and HCV coinfection. AIDS Care 2022; 34:1330-1337. [PMID: 34581640 PMCID: PMC8958183 DOI: 10.1080/09540121.2021.1981221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 09/13/2021] [Indexed: 01/26/2023]
Abstract
Hepatitis C virus (HCV) infection is common among people living with HIV. HIV and HCV coinfected patients have higher overall mortality rates compared with HIV mono-infected patients. With its high cure rate of HCV infection, direct-acting antiviral (DAA) treatment provides an opportunity to improve the survival of the HIV/HCV coinfected population. The objective of this study is to investigate the association between DAA treatment and all-cause mortality among HIV/HCV coinfected people. The study included 7103 Medicare beneficiaries in the United States who were infected with both HIV and HCV between 2014 and 2017. Cox proportional hazards regression model was used to estimate adjusted hazard ratios (aHRs) of death for patients with and without DAA treatment while controlling for patient characteristics. During the study period, 1675 patients initiated DAA treatment (23.6%). The adjusted hazard ratio (aHR) of all-cause mortality between patients with and without DAA treatment was 0.37 (95% CI, 0.29-0.48), regardless of cirrhosis status. DAA treatment was associated with a smaller reduction in all-cause mortality for females (aHR, 0.50 [95% CI, 0.30-0.85]) compared with males (aHR, 0.34 [95% CI, 0.25-0.46]). DAA treatment was associated with improved survival among all HIV/HCV coinfected patients regardless of sex or HCV disease progression.
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Affiliation(s)
- Xin Yin
- Department of Public Health Sciences, College of Medicine, The Pennsylvania State University, Hershey
| | - Lan Kong
- Department of Public Health Sciences, College of Medicine, The Pennsylvania State University, Hershey
| | - Ping Du
- Department of Medicine, College of Health and Human Development, The Pennsylvania State University, University Park
| | - Jeah Jung
- Department of Health Policy and Administration, College of Health and Human Development, The Pennsylvania State University, University Park
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A comprehensive analysis of avian lymphoid leukosis-like lymphoma transcriptomes including identification of LncRNAs and the expression profiles. PLoS One 2022; 17:e0272557. [PMID: 35939448 PMCID: PMC9359530 DOI: 10.1371/journal.pone.0272557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 07/21/2022] [Indexed: 11/22/2022] Open
Abstract
Avian lymphoid leukosis-like (LL-like) lymphoma has been observed in some experimental and commercial lines of chickens that are free of exogenous avian leukosis virus. Reported cases of avian lymphoid leukosis-like lymphoma incidences in the susceptible chickens are relatively low, but the apathogenic subgroup E avian leukosis virus (ALV-E) and the Marek’s disease vaccine, SB-1, significantly escalate the disease incidence in the susceptible chickens. However, the underlying mechanism of tumorigenesis is poorly understood. In this study, we bioinformatically analyzed the deep RNA sequences of 6 lymphoid leukosis-like lymphoma samples, collected from susceptible chickens post both ALV-E and SB-1 inoculation, and identified a total of 1,692 novel long non-coding RNAs (lncRNAs). Thirty-nine of those novel lncRNAs were detected with altered expression in the LL-like tumors. In addition, 13 lncRNAs whose neighboring genes also showed differentially expression and 2 conserved novel lncRNAs, XLOC_001407 and XLOC_022595, may have previously un-appreciated roles in tumor development in human. Furthermore, 14 lncRNAs, especially XLOC_004542, exhibited strong potential as competing endogenous RNAs via sponging miRNAs. The analysis also showed that ALV subgroup E viral gene Gag/Gag-pol and the MD vaccine SB-1 viral gene R-LORF1 and ORF413 were particularly detectable in the LL-like tumor samples. In addition, we discovered 982 novel lncRNAs that were absent in the current annotation of chicken genome and 39 of them were aberrantly expressed in the tumors. This is the first time that lncRNA signature is identified in avian lymphoid leukosis-like lymphoma and suggests the epigenetic factor, lncRNA, is involved with the avian lymphoid leukosis-like lymphoma formation and development in susceptible chickens. Further studies to elucidate the genetic and epigenetic mechanisms underlying the avian lymphoid leukosis-like lymphoma is indeed warranted.
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Mane A, Kasibhatla SM, Vidhate P, Saxena V, Patil S, Rao A, Nirmalkar A, Kulkarni-Kale U, Panda S. Phylogenetic Analysis of Spread of Hepatitis C Virus Identified during HIV Outbreak Investigation, Unnao, India. Emerg Infect Dis 2022; 28:725-733. [PMID: 35318918 PMCID: PMC8962895 DOI: 10.3201/eid2804.211845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
An HIV outbreak investigation during 2017–2018 in Unnao District, Uttar Pradesh, India, unearthed high prevalence of hepatitis C virus (HCV) antibodies among the study participants. We investigated these HCV infections by analyzing NS5B and core regions. We observed no correlation between HIV–HCV viral loads and clustering of HCV sequences, regardless of HIV serostatus. All HCV isolates belonged to genotype 3a. Monophyletic clustering of isolates in NS5B phylogeny indicates emergence of the outbreak from a single isolate or its closely related descendants. The nucleotide substitution rate for NS5B was 6 × 10−3 and for core was 2 × 10−3 substitutions/site/year. Estimated time to most recent common ancestor of these isolates was 2012, aligning with the timeline of this outbreak, which might be attributable to unsafe injection practices while seeking healthcare. HIV–HCV co-infection underlines the need for integrated testing, surveillance, strengthening of healthcare systems, community empowerment, and molecular analyses as pragmatic public health tools.
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Kase K, Avi R, Toompere K, Rajasaar H, Pauskar M, Soodla P, Jõgeda EL, Zilmer K, Lutsar I, Huik K. Dynamics of hepatitis C epidemic among people living with HIV in Estonia based on Estonian HIV cohort study. BMC Infect Dis 2021; 21:792. [PMID: 34376170 PMCID: PMC8353725 DOI: 10.1186/s12879-021-06521-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 08/03/2021] [Indexed: 11/21/2022] Open
Abstract
Background Estonia has a typical Eastern European HIV epidemic where the most frequent co-infection is chronic hepatitis C (HCV). We aimed to describe the changes in HCV prevalence, the distribution of HCV genotypes (GT), and HCV treatment in Estonian people living with HIV over 15 years. Methods We used data of subjects included to the Estonian HIV Cohort Study (E-HIV) before 31st of December 2015. We compared two time periods—first, 1st of January 2000 to 31st of December 2008 when the HIV epidemic was mostly spreading among people who inject drugs (PWID) and second, 1st of January 2009 to 31st of December 2015 when HIV started to emerge to the general population. Results Of 4422 HIV positives 3708 (84%) had information about their HCV serostatus; 2706 (61%) were HCV seropositive, of latter 1625 (60%) were HCV RNA positive, 239 (9%) had their HCV GT determined, and 141 (5%) received treatment for HCV. The dominating subtypes were 1b (42%) and 3a (37%) followed by 1a (16%), and the few cases of 2 (1.5%). HCV prevalence was 1.5 times (95% CI 1.4–1.6) higher in subjects diagnosed with HIV in first as compared to those diagnosed in second period (84% vs 56%, respectively). There were more men and the median age at HIV diagnosis was lower in HIV/HCV co-infected than in HIV mono-infected patients (70% vs 47% and 24 years vs. 30 years, respectively; both p < 0.001). Conclusion There is a decrease in HCV prevalence but it remains high among HIV positive PWID, suggesting that there is need for improvement of harm reduction programs among PWID.
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Affiliation(s)
- Kerstin Kase
- Department of Microbiology, Institute of Biological and Translational Medicine, Faculty of Medicine, University of Tartu, Ravila 19, 50411, Tartu, Estonia. .,Infectious Diseases Clinic, West-Tallinn Central Hospital, Tallinn, Estonia.
| | - Radko Avi
- Department of Microbiology, Institute of Biological and Translational Medicine, Faculty of Medicine, University of Tartu, Ravila 19, 50411, Tartu, Estonia
| | - Karolin Toompere
- Department of Epidemiology and Biostatistics, Institute of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Heli Rajasaar
- Department of Microbiology, Institute of Biological and Translational Medicine, Faculty of Medicine, University of Tartu, Ravila 19, 50411, Tartu, Estonia
| | - Merit Pauskar
- Department of Microbiology, Institute of Biological and Translational Medicine, Faculty of Medicine, University of Tartu, Ravila 19, 50411, Tartu, Estonia
| | - Pilleriin Soodla
- Department of Microbiology, Institute of Biological and Translational Medicine, Faculty of Medicine, University of Tartu, Ravila 19, 50411, Tartu, Estonia
| | - Ene-Ly Jõgeda
- Department of Microbiology, Institute of Biological and Translational Medicine, Faculty of Medicine, University of Tartu, Ravila 19, 50411, Tartu, Estonia
| | - Kai Zilmer
- Infectious Diseases Clinic, West-Tallinn Central Hospital, Tallinn, Estonia
| | - Irja Lutsar
- Department of Microbiology, Institute of Biological and Translational Medicine, Faculty of Medicine, University of Tartu, Ravila 19, 50411, Tartu, Estonia
| | - Kristi Huik
- Department of Microbiology, Institute of Biological and Translational Medicine, Faculty of Medicine, University of Tartu, Ravila 19, 50411, Tartu, Estonia.,HIV Dynamics and Replication Program, National Cancer Institute, National Institutes of Health, Frederick, MD, USA
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Quaranta MG, Ferrigno L, Tata X, D'Angelo F, Coppola C, Ciancio A, Bruno SR, Loi M, Giorgini A, Margotti M, Cossiga V, Brancaccio G, Dallio M, De Siena M, Cannizzaro M, Cavalletto L, Massari M, Mazzitelli M, De Leo P, Laccabue D, Baiocchi L, Kondili LA. Liver function following hepatitis C virus eradication by direct acting antivirals in patients with liver cirrhosis: data from the PITER cohort. BMC Infect Dis 2021; 21:413. [PMID: 33947337 PMCID: PMC8094561 DOI: 10.1186/s12879-021-06053-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 04/06/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The development of direct-acting antivirals (DAA) for HCV has revolutionized the treatment of HCV, including its treatment in patients with HIV coinfection. The aim of this study was to compare the changes in liver function between coinfected and monoinfected patients with cirrhosis who achieved HCV eradication by DAA. METHODS Patients with pre-treatment diagnosis of HCV liver cirrhosis, consecutively enrolled in the multicenter PITER cohort, who achieved a sustained virological response 12 weeks after treatment cessation (SVR12) were analysed. Changes in Child-Pugh (C-P) class and the occurrence of a decompensating event was prospectively evaluated after the end of DAA treatment. Cox regression analysis was used to evaluate factors independently associated with changes in liver function following viral eradication. RESULTS We evaluated 1350 patients, of whom 1242 HCV monoinfected (median follow-up 24.7, range 6.8-47.5 months after viral eradication) and 108 (8%) HCV/HIV coinfected (median follow-up 27.1, range 6.0-44.6). After adjusting for age, sex, HCV-genotype, HBsAg positivity and alcohol use, HIV was independently associated with a more advanced liver disease before treatment (C-P class B/C vs A) (OR: 3.73, 95% CI:2.00-6.98). Following HCV eradication, C-P class improved in 17/20 (85%) coinfected patients (from B to A and from C to B) and in 53/82 (64.6%) monoinfected patients (from B to A) (p = 0.08). C-P class worsened in 3/56 coinfected (5.3%) (from A to B) and in 84/1024 (8.2%) monoinfected patients (p = 0.45) (from A to B or C and from B to C). Baseline factors independently associated with C-P class worsening were male sex (HR = 2.00; 95% CI = 1.18-3.36), platelet count < 100,000/μl (HR = 1.75; 95% CI 1.08-2.85) and increased INR (HR = 2.41; 95% CI 1.51-3.84). Following viral eradication, in 7 of 15 coinfected (46.6%) and in 61 of 133 (45.8%) monoinfected patients with previous history of decompensation, a new decompensating event occurred. A first decompensating event was recorded in 4 of 93 (4.3%) coinfected and in 53 of 1109 (4.8%) monoinfected patients (p = 0.83). CONCLUSIONS Improvement of liver function was observed following HCV eradication in the majority of patients with cirrhosis; however viral eradication did not always mean cure of liver disease in both monoinfected and coinfected patients with advanced liver disease.
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Affiliation(s)
- Maria Giovanna Quaranta
- Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Luigina Ferrigno
- Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Xhimi Tata
- University of Tor Vergata, Nostra Signora del Buon Consiglio di Tirana, Tirana, Albania
| | - Franca D'Angelo
- Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | | | | | | | - Martina Loi
- Liver Unit, University Hospital, Monserrato, Cagliari, Italy
| | - Alessia Giorgini
- Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - Marzia Margotti
- Department of Internal Medicine, University Hospital of Modena, Modena, Italy
| | - Valentina Cossiga
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | | | - Marcello Dallio
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Martina De Siena
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marco Cannizzaro
- Internal Medicine, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Luisa Cavalletto
- Department of Medicine, University Hospital of Padua, Padua, Italy
| | - Marco Massari
- Infectious Diseases, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maria Mazzitelli
- Department of Infectious Disease, University Hospital Mater Domini, Catanzaro, Italy
| | | | - Diletta Laccabue
- Unit of Infectious Diseases and Hepatology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Leonardo Baiocchi
- Department of Medical Sciences, University of Tor Vergata, Rome, Italy
| | - Loreta A Kondili
- Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
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Liu L, Wang L, Zhang H, Ou W, Li D, Feng Y, Zhuang H, Shao Y. Changing Epidemiology of Hepatitis B Virus and Hepatitis C Virus Coinfection in a Human Immunodeficiency Virus-Positive Population in China: Results From the Third and Fourth Nationwide Molecular Epidemiologic Surveys. Clin Infect Dis 2021; 73:642-649. [PMID: 34398954 DOI: 10.1093/cid/ciab058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/21/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The transmission of human immunodeficiency virus (HIV) and hepatitis B virus (HBV)/hepatitis C virus (HCV) is similar in modes/routes and related risk factors. Understanding the long-term changing epidemiology of HIV, HBV, and HCV coinfection is important for evaluation of existing disease control policy and healthcare planning. We describe HBV and HCV coinfection based on the latest 2 nationwide molecular epidemiologic surveys of HIV infection in mainland China in 2007 and 2015. METHODS Seroprevalence of HBV and HCV infections was determined in antiretroviral treatment (ART)-naive people living with HIV-1 (PLWH) from 2 nationwide surveys conducted in 2007 and 2015 from 31 provinces, municipalities, and autonomous regions in mainland China. Demographic characteristics, route of HIV transmission, and CD4+ cell count were captured in the national database. Logistic regression was used to study the association between coinfection status and possible relevant risk factors. RESULTS A total of 6611 (n = 1571 in 2007; n = 5040 in 2015) ART-naive PLWH met the eligibility criteria. The prevalence of HBV and HCV coinfection in PLWH decreased from 61.1% in 2007 to 18.0% in 2015. Significant coinfection proportion reduction was found for HCV (from 53.7% to 4.9%), and a moderate decrease for HBV (17.8% to 13.9%). There was an increase of HBV/HIV coinfections among 12 provinces, municipalities, and autonomous regions, associated with domestic migration (adjusted odds ratio, 6.34 [95% confidence interval, 1.82-22.09]). CONCLUSIONS A significant decrease of HBV and HCV coinfection in PLWH was observed. Due to limited health resources and high transmission efficiency, concerted efforts should be made to further control viral hepatitis epidemics in HIV-positive populations.
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Affiliation(s)
- Lin Liu
- State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Changping District, Beijing, China
| | - Lin Wang
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| | - Hua Zhang
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Weidong Ou
- State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Changping District, Beijing, China
| | - Dan Li
- State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Changping District, Beijing, China
| | - Yi Feng
- State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Changping District, Beijing, China
| | - Hui Zhuang
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| | - Yiming Shao
- State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Changping District, Beijing, China.,Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
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Ameha Z, Tadesse S, Assefa A, Tessema B. Prevalence and associated factors of Hepatitis C virus and human immunodeficiency virus infections among voluntary counseling and testing clients attending private health facilities in Bahir Dar city, North West Ethiopia 2014. BMC Res Notes 2019; 12:693. [PMID: 31653230 PMCID: PMC6815064 DOI: 10.1186/s13104-019-4727-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 10/12/2019] [Indexed: 11/28/2022] Open
Abstract
Objective Although incredible progress has been made in treatment and prevention of Hepatitis C virus and human immunodeficiency virus infections, the epidemic continues to spread in developing nations. The information on the prevalence and risk factors of Hepatitis C virus and human immunodeficiency virus infections among voluntary counseling and testing clients in Ethiopia is limited. Hence, the study aimed to assess the prevalence and associated factors of Hepatitis C virus and human immunodeficiency virus infections among voluntary counseling and testing clients attending private health facilities in Bahir Dar city. Result A total of 382 study participants with the mean age of 25.43 years (SD = ± 6.87) were enrolled. Overall, 14 (3.7%) and 8 (2.1%) voluntary counseling and testing clients were positive for human immunodeficiency virus and Hepatitis C virus respectively. All Hepatitis C virus antibody positive individuals were males (3.8%). The sero-prevalence of Hepatitis C virus was significantly associated with the age group 41–50 years old (AOR = 65.65; 95% CI 4.57–943). Married study participants were also significantly associated with HIV infection (AOR = 7.92, 95% CI 1.32–47.31).
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Affiliation(s)
- Zena Ameha
- Amhara Public Health Institute, Bahir Dar, Ethiopia
| | - Senait Tadesse
- Medical Laboratory Science Department, Health Science College, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Abate Assefa
- University of Gondar Colleges of Medicine and Health Sciences (CMHS), Gondar, Ethiopia
| | - Belay Tessema
- University of Gondar Colleges of Medicine and Health Sciences (CMHS), Gondar, Ethiopia
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9
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Malin JJ, Boesecke C, Schwarze-Zander C, Wasmuth JC, Schlabe S, Trebicka J, Spengler U, Llibre JM, Jou T, Vasylyev M, Clotet B, Rockstroh JK. Liver stiffness regression after successful Hepatitis C treatment is independent of HIV coinfection. HIV Med 2019; 20:230-236. [PMID: 30687989 DOI: 10.1111/hiv.12705] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVES The aim of the study was to assess the regression of liver stiffness after successful direct-acting antiviral (DAA) treatment in patients with hepatitis C virus (HCV) monoinfection and HCV/-HIV coinfection. In addition, we aimed to identify factors associated with liver stiffness regression. METHODS We studied patients treated with interferon-free DAA regimens with a sustained virological response at week 12 (SVR12 ) or 24 (SVR24 ) post-treatment. Liver stiffness was assessed by transient elastography (TE) before the initiation and after the end of treatment (median 12 weeks). RESULTS Of 214 enrolled patients, 85 (40%) were HCV monoinfected and 129 (60%) HCV/HIV coinfected. Baseline median TE values were 7.8 kPa [interquartile range (IQR) 5.9-12.0 kPa] in mono-infected patients and 10.7 kPa (IQR 7.8-17.0 kPa) in coinfected patients. Overall, the median TE value decreased from 10.1 to 6.8 kPa (n = 214; P < 0.0001). There was no difference between mono- and coinfected patients (-2.2 versus -3.3 kPa, respectively; P = 0.88), which was verified by an analysis of covariance (ANCOVA) adjusting for baseline TE values. Significant (≥ 30%) regression of liver stiffness was achieved by 45% of patients (54% with baseline TE ≥ 7.1 kPa). In multivariate analysis, a prior HCV treatment was a negative predictor of liver stiffness regression [odds ratio (OR) 0.31; P = 0.001]. A higher baseline TE value was positively associated with achieving a significant regression (OR 1.06; P = 0.02). HIV coinfection status, HCV genotype, age, sex, treatment duration, controlled attenuation parameter value, bilirubin concentration, platelet count and aspartate aminotransferase concentration were not associated with liver stiffness regression. CONCLUSIONS Regression of liver stiffness after successful DAA treatment did not differ in patients with HCV monoinfection and those with HCV/HIV coinfection. Half of all patients achieved a significant (≥ 30%) regression. Prior treatment for HCV was a negative predictor for this endpoint, while a higher baseline TE value was positively associated with regression.
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Affiliation(s)
- J J Malin
- Department of Internal Medicine I, University Hospital Cologne, Cologne, Germany
| | - C Boesecke
- Department of Medicine I, Bonn University Hospital, Bonn, Germany
| | | | - J C Wasmuth
- Department of Medicine I, Bonn University Hospital, Bonn, Germany
| | - S Schlabe
- Department of Medicine I, Bonn University Hospital, Bonn, Germany
| | - J Trebicka
- Department of Medicine I, Bonn University Hospital, Bonn, Germany.,European Foundation for Study of Chronic Liver Failure, Barcelona, Spain.,Medical Department I, Goethe University Clinic Frankfurt, Frankfurt, Germany
| | - U Spengler
- Department of Medicine I, Bonn University Hospital, Bonn, Germany
| | - J M Llibre
- Department of Infectious Diseases, University Hospital "Germans Trias i Pujol", Badalona, Spain
| | - T Jou
- Department of Infectious Diseases, University Hospital "Germans Trias i Pujol", Badalona, Spain
| | - M Vasylyev
- HIV Unit Lviv Regional Public Health Center, Lviv, Ukraine
| | - B Clotet
- Irsicaixa Foundation, University Hospital "Germans Trias i Pujol", Badalona, Spain
| | - J K Rockstroh
- Department of Medicine I, Bonn University Hospital, Bonn, Germany
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Abstract
Coinfections involving viruses are being recognized to influence the disease pattern that occurs relative to that with single infection. Classically, we usually think of a clinical syndrome as the consequence of infection by a single virus that is isolated from clinical specimens. However, this biased laboratory approach omits detection of additional agents that could be contributing to the clinical outcome, including novel agents not usually considered pathogens. The presence of an additional agent may also interfere with the targeted isolation of a known virus. Viral interference, a phenomenon where one virus competitively suppresses replication of other coinfecting viruses, is the most common outcome of viral coinfections. In addition, coinfections can modulate virus virulence and cell death, thereby altering disease severity and epidemiology. Immunity to primary virus infection can also modulate immune responses to subsequent secondary infections. In this review, various virological mechanisms that determine viral persistence/exclusion during coinfections are discussed, and insights into the isolation/detection of multiple viruses are provided. We also discuss features of heterologous infections that impact the pattern of immune responsiveness that develops.
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Kamiya T, Mideo N, Alizon S. Coevolution of virulence and immunosuppression in multiple infections. J Evol Biol 2018; 31:995-1005. [DOI: 10.1111/jeb.13280] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 03/19/2018] [Accepted: 03/29/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Tsukushi Kamiya
- Department of Ecology & Evolutionary Biology; University of Toronto; Toronto ON Canada
| | - Nicole Mideo
- Department of Ecology & Evolutionary Biology; University of Toronto; Toronto ON Canada
| | - Samuel Alizon
- Laboratoire MIVEGEC (UMR CNRS 5290, UR IRD 224, UM); Montpellier France
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Dehghani-Dehej F, Sarvari J, Esghaei M, Hosseini SY, Garshasbi S, Kalantari S, Monavari SH, Fakhim A, Keyvani H, Bokharaei-Salim F. Presence of different hepatitis C virus genotypes in plasma and peripheral blood mononuclear cell samples of Iranian patients with HIV infection. J Med Virol 2018; 90:1343-1351. [DOI: 10.1002/jmv.24925] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 07/31/2017] [Indexed: 01/05/2023]
Affiliation(s)
- Farzaneh Dehghani-Dehej
- Department of Bacteriology and Virology; School of Medicine; Shiraz University of Medical Sciences; Shiraz Iran
| | - Jamal Sarvari
- Department of Bacteriology and Virology; School of Medicine; Shiraz University of Medical Sciences; Shiraz Iran
- Gastroenterohepatology Research Center; Shiraz University of Medical Sciences; Shiraz Iran
| | - Maryam Esghaei
- Department of Virology; School of Medicine; Iran University of Medical Sciences; Tehran Iran
| | - Seyed Y. Hosseini
- Department of Bacteriology and Virology; School of Medicine; Shiraz University of Medical Sciences; Shiraz Iran
| | - Saba Garshasbi
- HIV Laboratory of National Center; Deputy of Health; Iran University of Medical Sciences; Tehran Iran
| | - Saeed Kalantari
- Departments of Infectious Diseases and Tropical Medicine; Iran University of Medical Sciences; Tehran Iran
| | - Seyed H. Monavari
- Department of Virology; School of Medicine; Iran University of Medical Sciences; Tehran Iran
| | - Atousa Fakhim
- Department of Architectural Engineering; Faculty of Engineering; Islamic Azad University; South Tehran Branch; Tehran Iran
| | - Hossein Keyvani
- Department of Virology; School of Medicine; Iran University of Medical Sciences; Tehran Iran
| | - Farah Bokharaei-Salim
- Department of Virology; School of Medicine; Iran University of Medical Sciences; Tehran Iran
- HIV Laboratory of National Center; Deputy of Health; Iran University of Medical Sciences; Tehran Iran
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Abstract
The individuals with HIV infection are more susceptible to develop coinfections with infectious pathogens such as HCV and HBV. The routes of transmission of these pathogens are the same including sexual contact, injection drug use, or at birth from mother to an infant. The main reason of morbidity and mortality in HIV infected individuals is a liver disease in the context of antiretroviral therapy, and coinfection such as HCV and HBV complicates this condition. Nucleos(t)ide analogues are used for HBV infection management, and treatment of HCV infection is done by PegIFN and ribavirin combination and protease inhibitors. In this review, we focused on hepatitis B and C infections in HIV patients along with their therapies.
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Affiliation(s)
- Muhammad Imran Qadir
- Institute of Molecular Biology and Biotechnology, Bahauddin Zakariya University, Multan, Pakistan
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14
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Salemovic D, Pesic-Pavlovic I, Jevtovic D, Bojovic K, Ranin J, Brmbolic B, Stanojevic M. Intravenous drug use - an independent predictor for HCV genotypes 3 and 4 infection among HIV/HCV co-infected patients. Arch Med Sci 2017; 13:652-658. [PMID: 28507583 PMCID: PMC5420631 DOI: 10.5114/aoms.2017.66022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 07/02/2015] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION About one quarter of human immunodeficiency virus (HIV) infected persons in Serbia have also been found to be hepatitis C virus (HCV) co-infected. In the general population, HCV genotype 1 has been shown to be the most prevalent one. Here, we present the first study on the distribution of HCV genotypes among HIV/HCV co-infected patients in Serbia, in relation to epidemiological and clinical features. MATERIAL AND METHODS The study included HIV/HCV co-infected and a group of HCV mono-infected patients in the period 1998-2012, with collection of epidemiological, clinical, and behavioral data using a standardized questionnaire. The HCV genotyping to the level of pure genotype was performed by reverse hybridization. RESULTS Intravenous drug use (IDU) was found to be significantly more prevalent among the co-infected patients (p < 0.01). HCV genotype 1 was detected in 87% of patients with mono-infection, compared to 46.3% of patients with co-infection (p < 0.01); genotypes 3 and 4 were significantly more common among co-infected patients (6% and 5%, vs. 27% and 25%, respectively). Multivariate logistic regression confirmed IDU, infection with non-1 HCV genotype and HCV viral load over 5 log to be predictors of HIV co-infection. CONCLUSIONS The HCV genotypes 3 and 4 were found to be significantly more prevalent among HIV/HCV co-infected patients in Serbia, compared to HCV mono-infected patients, but also more prevalent compared to the European HIV/HCV co-infected cohort. History of IDU represents an independent predictor of HCV genotypes 3 and 4 infection, with important implications for treatment.
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Affiliation(s)
- Dubravka Salemovic
- Infectious and Tropical Diseases University Hospital, Clinical Center Serbia, HIV/AIDS Unit, Belgrade, Serbia
| | | | - Djordje Jevtovic
- Infectious and Tropical Diseases University Hospital, Clinical Center Serbia, HIV/AIDS Unit, Belgrade, Serbia
- University of Belgrade Faculty of Medicine, Belgrade, Serbia
| | - Ksenija Bojovic
- Infectious and Tropical Diseases University Hospital, Clinical Center Serbia, HIV/AIDS Unit, Belgrade, Serbia
| | - Jovan Ranin
- Infectious and Tropical Diseases University Hospital, Clinical Center Serbia, HIV/AIDS Unit, Belgrade, Serbia
- University of Belgrade Faculty of Medicine, Belgrade, Serbia
| | - Branko Brmbolic
- Infectious and Tropical Diseases University Hospital, Clinical Center Serbia, HIV/AIDS Unit, Belgrade, Serbia
- University of Belgrade Faculty of Medicine, Belgrade, Serbia
| | - Maja Stanojevic
- Institute of Microbiology and Immunology, NRL HIV/AIDS, University of Belgrade School of Medicine, Belgrade, Serbia
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Hartling HJ, Ballegaard VC, Nielsen NS, Gaardbo JC, Nielsen SD. Immune regulation in chronic hepatitis C virus infection. Scand J Gastroenterol 2016; 51:1387-97. [PMID: 27436030 DOI: 10.3109/00365521.2016.1170875] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The immunological result of infection with Hepatitis C virus (HCV) depends on the delicate balance between a vigorous immune response that may clear the infection, but with a risk of unspecific inflammation and, or a less inflammatory response that leads to chronic infection. In general, exhaustion and impairment of cytotoxic function of HCV-specific T cells and NK cells are found in patients with chronic HCV infection. In contrast, an increase in immune regulatory functions is found primarily in form of increased IL-10 production possibly due to increased level and function of anti-inflammatory Tregs. Thus, the major immune players during chronic HCV infection are characterized by a decrease of cytotoxic function and increase of inhibitory functions. This may be an approach to diminish intrahepatic and systemic inflammation. Finally, there has been increasing awareness of regulatory functions of epigenetic changes in chronic HCV infection. A vast amount of studies have revealed the complexity of immune regulation in chronic HCV infection, but the interplay between immune regulation in virus and host remains incompletely understood. This review provides an overview of regulatory functions of HCV-specific T cells, NK cells, Tregs, IL-10, and TGF-β, as well as epigenetic changes in the setting of chronic HCV infection.
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Affiliation(s)
- Hans Jakob Hartling
- a Viro-Immunology Research Unit, Department of Infectious Diseases , University of Copenhagen , Rigshospitalet , Denmark
| | - Vibe Cecilie Ballegaard
- a Viro-Immunology Research Unit, Department of Infectious Diseases , University of Copenhagen , Rigshospitalet , Denmark
| | - Nick Schou Nielsen
- a Viro-Immunology Research Unit, Department of Infectious Diseases , University of Copenhagen , Rigshospitalet , Denmark
| | - Julie Christine Gaardbo
- a Viro-Immunology Research Unit, Department of Infectious Diseases , University of Copenhagen , Rigshospitalet , Denmark
| | - Susanne Dam Nielsen
- a Viro-Immunology Research Unit, Department of Infectious Diseases , University of Copenhagen , Rigshospitalet , Denmark
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Lifson MA, Ozen MO, Inci F, Wang S, Inan H, Baday M, Henrich TJ, Demirci U. Advances in biosensing strategies for HIV-1 detection, diagnosis, and therapeutic monitoring. Adv Drug Deliv Rev 2016; 103:90-104. [PMID: 27262924 PMCID: PMC4943868 DOI: 10.1016/j.addr.2016.05.018] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 05/24/2016] [Accepted: 05/25/2016] [Indexed: 01/01/2023]
Abstract
HIV-1 is a major global epidemic that requires sophisticated clinical management. There have been remarkable efforts to develop new strategies for detecting and treating HIV-1, as it has been challenging to translate them into resource-limited settings. Significant research efforts have been recently devoted to developing point-of-care (POC) diagnostics that can monitor HIV-1 viral load with high sensitivity by leveraging micro- and nano-scale technologies. These POC devices can be applied to monitoring of antiretroviral therapy, during mother-to-child transmission, and identification of latent HIV-1 reservoirs. In this review, we discuss current challenges in HIV-1 diagnosis and therapy in resource-limited settings and present emerging technologies that aim to address these challenges using innovative solutions.
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Affiliation(s)
- Mark A Lifson
- Demirci Bio-Acoustic-MEMS in Medicine (BAMM) Laboratory, Radiology Department, Canary Center at Stanford for Cancer Early Detection, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Mehmet Ozgun Ozen
- Demirci Bio-Acoustic-MEMS in Medicine (BAMM) Laboratory, Radiology Department, Canary Center at Stanford for Cancer Early Detection, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Fatih Inci
- Demirci Bio-Acoustic-MEMS in Medicine (BAMM) Laboratory, Radiology Department, Canary Center at Stanford for Cancer Early Detection, Stanford University School of Medicine, Palo Alto, CA, USA
| | - ShuQi Wang
- Demirci Bio-Acoustic-MEMS in Medicine (BAMM) Laboratory, Radiology Department, Canary Center at Stanford for Cancer Early Detection, Stanford University School of Medicine, Palo Alto, CA, USA; State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China; Institute for Translational Medicine, Zhejiang University, Hangzhou, China
| | - Hakan Inan
- Demirci Bio-Acoustic-MEMS in Medicine (BAMM) Laboratory, Radiology Department, Canary Center at Stanford for Cancer Early Detection, Stanford University School of Medicine, Palo Alto, CA, USA; Medicine Faculty, Zirve University, Gaziantep, Turkey
| | - Murat Baday
- Demirci Bio-Acoustic-MEMS in Medicine (BAMM) Laboratory, Radiology Department, Canary Center at Stanford for Cancer Early Detection, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Timothy J Henrich
- Division of Experimental Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Utkan Demirci
- Demirci Bio-Acoustic-MEMS in Medicine (BAMM) Laboratory, Radiology Department, Canary Center at Stanford for Cancer Early Detection, Stanford University School of Medicine, Palo Alto, CA, USA
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Hepatitis C virus and HIV seroprevalences, sociodemographic characteristics, behaviors and access to syringes among drug users, a comparison of geographical areas in France, ANRS-Coquelicot 2011 survey. Rev Epidemiol Sante Publique 2016; 64:301-12. [PMID: 26904917 DOI: 10.1016/j.respe.2015.10.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 09/10/2015] [Accepted: 10/19/2015] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND People who use drugs (PWUDs) are at a high risk for hepatitis C virus (HCV) and human immunodeficiency virus (HIV), but they have different characteristics depending on the local context. In France, seroprevalence, sociodemographic, and behavior information have only been studied at a national level rather than at a local level. The aim of this study was to describe and examine profile and drug use practice differences in seven French cities and departments and to assess whether these differences can explain HCV and HIV seroprevalence variations between French geographical areas. METHODS Data were collected from the cross-sectional ANRS-Coquelicot survey conducted for the second time in 2011 among drug users having injected or snorted drugs at least once in their life. Professional interviewers administrated a face-to-face questionnaire in six different areas in France: Paris, Marseille, Bordeaux, Lille, Strasbourg and the Seine-Saint-Denis department (Paris suburbs). Participants were asked to self-collect a fingerpick blood sample in order to search for the presence of anti-HIV and anti-HCV antibodies and to estimate seroprevalence in PWUDs. RESULTS Overall, HCV and HIV seroprevalence was 44% [95% CI: 39.6-47.9] and 10% [95% CI: 7.5-12.6] respectively. The highest HCV seroprevalence was 56% in Marseille and the lowest was 24% in Bordeaux and for HIV the highest was 18% in Seine-Saint-Denis and the lowest was 0% in Lille. The population's age differed between areas and could mostly explain HCV seroprevalence variation but not exclusively. Profiles and practices, different in each area, can also explain this variation. In multivariate analysis, HCV seroprevalence was lower in Bordeaux (prevalence ratio [PR]=0.64), Strasbourg (PR=0.76), and Seine-Saint-Denis (PR=0.8) than in Paris. Nearly one-third of injectors declared having had difficulties to obtain syringes in the 6 previous months, but disparities existed between areas. CONCLUSION HCV risk exposure in PWUDs remains high in France and varies between different areas. Innovative harm reduction strategies including educative programs about safe injecting and supervised consumption rooms need to be developed.
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Cenderello G, Artioli S, Viscoli C, Pasa A, Giacomini M, Giannini B, Dentone C, Nicolini LA, Cassola G, Di Biagio A. Budget impact analysis of sofosbuvir-based regimens for the treatment of HIV/HCV-coinfected patients in northern Italy: a multicenter regional simulation. CLINICOECONOMICS AND OUTCOMES RESEARCH 2015; 8:15-21. [PMID: 26770065 PMCID: PMC4706121 DOI: 10.2147/ceor.s93641] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Objectives Chronic hepatitis C virus (HCV) is a leading cause of hospitalization and death in populations coinfected with human immunodeficiency virus (HIV). Sofosbuvir (SOF) is a pan-genotypic drug that should be combined with other agents as an oral treatment for HCV. We performed a 5-year horizon budget impact analysis of SOF-based regimens for the management of HIV/HCV-coinfected patients. Methods A multicenter, prospective evaluation was conducted, involving four Italian Infectious Diseases Departments (Galliera, San Martino, Sanremo, and La Spezia). All 1,005 genotype-coinfected patients (30% cirrhotics) under observation were considered (patients in all disease-stages were considered: chronic hepatitis C, cirrhosis, transplant, hepatocellular carcinoma). Disease stage costs per patient were collected; the expected disease progression in the absence of treatment and sustained virological response (SVR) success rate for SOF-based regimens were calculated based on the literature and expert opinion. Drug prices were based on what the National Health Service paid for them. The comparison of “no treatment” disease progression costs versus the economic impact of SOF-based regimens was investigated. Results Over the following 5 years, the disease progression scenario resulted in direct costs of approximately €54 million. Assuming an SVR success rate of 90%, average SOF-based regimens cost up to €50,000 per person, resulting in a final cost of more than €56 million, so this option is not economically viable. At the average price of €12,000, SOF-based regimens, expense was €17 million, saving 68%. At this price level, the economic resources invested in treating mild to moderate fibrosis stage patients would be equal to the amount of direct costs of disease management in this stage, resulting in a valid return of investment in the short-term. Conclusion Given the high rates of SVR, in the Italian Healthcare System, SOF-based regimens, price is a determinant and a predictor of the overall cost for the Hepatitis C patient’s management. At the average price per therapy of €12,000 over the next 5 years, SOF-based regimens are becoming highly sustainable.
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Affiliation(s)
| | | | - Claudio Viscoli
- Infectious Diseases Unit, A San Martino, IST, Genoa University, Genoa, Italy
| | - Ambra Pasa
- IT Unit, Ospedali Galliera, Genoa, Italy
| | - Mauro Giacomini
- Department of Informatics, Bioengineering, Robotics and System Engineering (DIBRIS), University of Genoa, Genova, Italy
| | - Barbara Giannini
- Department of Informatics, Bioengineering, Robotics and System Engineering (DIBRIS), University of Genoa, Genova, Italy
| | - Chiara Dentone
- Infectious Diseases Unit, ASL-1 Imperiese, Sanremo, Imperia, Italy
| | | | | | - Antonio Di Biagio
- Infectious Diseases Unit, A San Martino, IST, Genoa University, Genoa, Italy
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Latypov A, Grund JP, El-Bassel N, Platt L, Stöver H, Strathdee S. Illicit drugs in Central Asia: what we know, what we don’t know, and what we need to know. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2015; 25:1155-62. [PMID: 25449055 DOI: 10.1016/j.drugpo.2014.09.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Daw MA, El-Bouzedi A, Dau AA. Geographic distribution of HCV genotypes in Libya and analysis of risk factors involved in their transmission. BMC Res Notes 2015; 8:367. [PMID: 26293137 PMCID: PMC4545908 DOI: 10.1186/s13104-015-1310-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 07/30/2015] [Indexed: 12/17/2022] Open
Abstract
Background Hepatitis C virus (HCV) genotypes have been shown to be differently distributed between distinct geographical areas. Libya is a large country has the longest coast in the Mediterranean basin. Information regarding hepatitis C genotypes and subtypes circulating in Libya are not well known. The objectives of this study were to determine the frequency of various HCV genotypes cross Libya and the demographic and attributable risk factors associated with HCV transmission among Libyan population. Methods A cross-sectional study was carried out on patients with recently confirmed HCV infection. A total of 3,227 serum samples enrolled at 19 collection center cross Libya. 1,756 belonged to Tripoli region, 452 to West region 355 to North region, 181 South regions and 483 East region. The samples were tested by type specific genotyping assay and correlated with demographic and potential risk factors within the studied populations. Results A total of 20 discrete genotypes and subtypes were identified among the Libyan population ranging from 11.5 to 0.3 % cross the country. Genotype 1 was the most frequent among all regions (19.7–40.5 %), reaching the highest value in Tripoli region, followed by genotype 4 which was more prevalent in the South (49.3 %) and West (40.0 %) regions. Genotype 3, was higher in Tripoli (21.3 %) and East (15.9 %) regions while genotype 2, common in North (23.6 %) and South (22.5 %) regions. However, we found evidence that there is a changing relative prevalence of HCV genotypes in relation to age, gender and the mode of transmission which is reflected in the predominance of certain genotypes among Libyan population. Conclusions Different HCV genotypes were isolated form Libyan population including newly emerged ones. The prevalence of the genotypes varied by geographic region and influenced by demographic and risk factors. Knowing the frequency and distribution of the genotypes would provide key information on understanding the spread of HCV in Libya and this could be greatly reflected on national plans and future strategies for infection prevention.
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Affiliation(s)
- Mohamed A Daw
- Department of Medical Microbiology, Faculty of Medicine, Tripoli University, 82668, Tripoli, Libya. .,Libyan National Surveillance Studies of Viral Hepatitis & HIV, Tripoli, Libya.
| | - Abdallah El-Bouzedi
- Department of Laboratory Medicine, Faculty of Biotechnology, Tripoli University, 82668, Tripoli, Libya.
| | - Aghnaya A Dau
- Department of Surgery, Faculty of Medicine, Tripoli Medical Center, Tripoli, Libya.
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Genetic Variability of Hepatitis C Virus (HCV) 5' Untranslated Region in HIV/HCV Coinfected Patients Treated with Pegylated Interferon and Ribavirin. PLoS One 2015; 10:e0125604. [PMID: 25932941 PMCID: PMC4416933 DOI: 10.1371/journal.pone.0125604] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 03/24/2015] [Indexed: 01/03/2023] Open
Abstract
Association between hepatitis C virus (HCV) quasispecies and treatment outcome among patients with chronic hepatitis C has been the subject of many studies. However, these studies focused mainly on viral variable regions (E1 and E2) and usually did not include human immunodeficiency virus (HIV)-positive patients. The aim of the present study was to analyze heterogeneity of the 5' untranslated region (5'UTR) in HCV/HIV coinfected patients treated with interferon and ribavirin. The HCV 5'UTR was amplified from serum and peripheral blood mononuclear cells (PBMC) samples in 37 HCV/HIV coinfected patients treated for chronic hepatitis C. Samples were collected right before treatment, and at 2, 4, 6, 8, 12, 20, 24, 36, 44, 48, 60, and 72 weeks. Heterogeneity of the 5'UTR was analyzed by single strand conformational polymorphism (SSCP), cloning and sequencing. Sustained virological response (SVR) was achieved in 46% of analyzed HCV/HIV co-infected patients. Stable SSCP band pattern was observed in 22 patients (62.9%) and SVR rate among these patients was 23%. Decline in the number of bands and/or shift in band positions were found in 6 patients (17.1%), 5 (83%) of whom achieved SVR (p=0.009). A novel viral genotype was identified in all but one of these patients. In 5 of these 6 patients a new genotype was dominant. 5'UTR heterogeneity may correlate with interferon and ribavirin treatment outcome. In the analyzed group of HCV/HIV coinfected patients, viral quasispecies stability during treatment favored viral persistence, whereas decrease in the number of variants and/or emergence of new variants was associated with SVR. Among injection drug users (IDU) patients, a new genotype may become dominant during treatment, probably due to the presence of mixed infections with various strains, which have different susceptibility to treatment.
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Cacoub P, Dabis F, Costagliola D, Almeida K, Lert F, Piroth L, Semaille C. Burden of HIV and hepatitis C co-infection: the changing epidemiology of hepatitis C in HIV-infected patients in France. Liver Int 2015; 35:65-70. [PMID: 25040895 DOI: 10.1111/liv.12639] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 07/05/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS To better evaluate the HIV-HCV co-infection burden in the context of new effective HCV treatment. METHODS We reviewed all the epidemiological data available on HCV-related disease in HIV-infected patients in France. Sources of data have been selected using the following criteria: (i) prospective cohorts or cross-sectional surveys; (ii) conducted at a national level; (iii) in the HIV-infected population; (iv) able to identify HCV co-infection and chronic active hepatitis C (HCV RNA positive); and (v) conducted during the period 2003-2012. RESULTS The overall prevalence of HIV-HCV co-infection has decreased from 22-24% to 16-18%. This prevalence decreased from 93% to 87% among injecting drug users while it increased from 4% to 6% among men who have sex with men. The characteristics of patients have changed: decrease in the proportion of patients with chronic active hepatitis C (HCV RNA positive) from 77% to 63% and in the genotypes 2 and 3 HCV infection; increase in the proportion of HCV genotype 1 (from 45-50% to 58%) and genotype 4 (from 15% to 22%). The proportion of patients treated with highly active antiretroviral therapy increased from 76% to 95%, with higher rates of undetectable HIV viral load (47% in 2004 vs. 85% in 2012). CONCLUSION The decreasing prevalence and the change in patients profile in HIV-HCV co-infection underline the importance of continuing efforts to educate physicians and patients. This should increase the benefit of viral risk reduction policies and increase the access of co-infected patients to HCV treatment.
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Affiliation(s)
- Patrice Cacoub
- Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Sorbonne Universités, UMR 7211, UPMC Univ Paris 06, Paris, F-75005, France; INSERM, UMR_S 959, Paris, F-75013, France; CNRS, FRE3632, Paris, F-75005, France; Department of Internal Medicine and Clinical Immunology, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, F-75013, France
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Zhang F, Zhu H, Wu Y, Dou Z, Zhang Y, Kleinman N, Bulterys M, Wu Z, Ma Y, Zhao D, Liu X, Fang H, Liu J, Cai WP, Shang H. HIV, hepatitis B virus, and hepatitis C virus co-infection in patients in the China National Free Antiretroviral Treatment Program, 2010-12: a retrospective observational cohort study. THE LANCET. INFECTIOUS DISEASES 2014; 14:1065-1072. [PMID: 25303841 DOI: 10.1016/s1473-3099(14)70946-6] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Hepatitis-related liver diseases are a leading cause of mortality and morbidity among people with HIV/AIDS taking combination antiretroviral therapy. We assessed the effect of hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infection on HIV outcomes in patients in China. METHODS We did a nationwide retrospective observational cohort study with data from the China National Free Antiretroviral Treatment Program from 2010-11. Patients older than 18 years starting standard antiretroviral therapy for HIV who had tested positive for HBV and HCV were followed up to Dec 31, 2012. We used Kaplan-Meier analysis and Cox proportional hazard models to evaluate survival, and logistic regression models to estimate virological failure, immunological response, and retention in care. FINDINGS 33 861 patients with HIV met eligibility criteria. 2958 (8·7%) participants had HBV co-infection, 6149 (18·2%) had HCV co-infection, and 1114 (3·3%) had triple infection. All-cause mortality was higher in participants with triple infection (adjusted hazard ratio 1·90, 95% CI 1·53-2·37) and HCV co-infection (1·46, 1·25-1·70) than in those with HIV only, but not in those with HBV co-infection (1·06, 0·89-1·26). People with triple infection were also more likely to have virological failure (adjusted odds ratio [OR] 1·26, 95% CI 1·02-1·56) than were those with HIV only, whereas the difference was not significant for those with HBV co-infection (0·93, 0·80-1·10) or HCV co-infection (1·10, 0·97-1·26). No co-infection was significantly associated with a difference in CD4 cell count after 1 year of treatment. Loss to follow-up was more common among participants with triple infection (OR 1·37, 95% CI 1·16-1·62) and HCV co-infection (1·30, 1·17-1·45), but not HBV co-infection (0·93, 0·82-1·05), than among those with HIV only. INTERPRETATION Screening for viral hepatitis is important in individuals diagnosed as HIV positive. Effective management for viral hepatitis should be integrated into HIV treatment programmes. Long-term data are needed about the effect of hepatitis co-infection on HIV disease progression. FUNDING The National Center for AIDS/STD Control and Prevention, China Center for Disease Control and Prevention.
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Affiliation(s)
- Fujie Zhang
- National Center for AIDS/STD Control and Prevention, China Center for Disease Control and Prevention, Beijing, China; First Affiliated Hospital of China Medical University, Liaoning, China
| | - Hao Zhu
- Global AIDS Program, China Office, US Centers for Disease Control and Prevention, Beijing, China
| | - Yasong Wu
- National Center for AIDS/STD Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
| | - Zhihui Dou
- National Center for AIDS/STD Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
| | - Yao Zhang
- National Center for AIDS/STD Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
| | - Nora Kleinman
- Global AIDS Program, China Office, US Centers for Disease Control and Prevention, Beijing, China; Association of Schools and Programs of Public Health, Washington, DC, USA
| | - Marc Bulterys
- Global AIDS Program, China Office, US Centers for Disease Control and Prevention, Beijing, China; Department of Defense HIV/AIDS Prevention Program, Naval Health Research Center, San Diego, CA, USA
| | - Zunyou Wu
- National Center for AIDS/STD Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
| | - Ye Ma
- National Center for AIDS/STD Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
| | - Decai Zhao
- National Center for AIDS/STD Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
| | - Xia Liu
- National Center for AIDS/STD Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
| | - Hua Fang
- National Center for AIDS/STD Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
| | - Jing Liu
- First Affiliated Hospital of China Medical University, Liaoning, China
| | - Wei-Ping Cai
- Department of Infectious Diseases, Guang Zhou Eighth People's Hospital, Guangdong, China
| | - Hong Shang
- First Affiliated Hospital of China Medical University, Liaoning, China.
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24
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Wilson EM, Bial J, Tarlow B, Bial G, Jensen B, Greiner DL, Brehm MA, Grompe M. Extensive double humanization of both liver and hematopoiesis in FRGN mice. Stem Cell Res 2014; 13:404-12. [PMID: 25310256 PMCID: PMC7275629 DOI: 10.1016/j.scr.2014.08.006] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 08/21/2014] [Accepted: 08/27/2014] [Indexed: 11/21/2022] Open
Abstract
Preclinical research in animals often fails to adequately predict the outcomes observed in human patients. Chimeric animals bearing individual human tissues have been developed to provide improved models of human-specific cellular processes. Mice transplanted with human hematopoietic stem cells can be used to study human immune responses, infections of blood cells and processes of hematopoiesis. Animals with humanized livers are useful for modeling hepatotropic infections as well as drug metabolism and hepatotoxicity. However, many pathophysiologic processes involve both the liver and the hematolymphoid system. Examples include hepatitis C/HIV co-infection, immune mediated liver diseases, liver injuries with inflammation such as steatohepatitis and alcoholic liver disease. We developed a robust protocol enabling the concurrent double-humanization of mice with mature hepatocytes and human blood. Immune-deficient, fumarylacetoacetate hydrolase (Fah−/−), Rag2−/− and Il2rg−/− deficient animals on the NOD-strain background (FRGN) were simultaneously co-transplanted with adult human hepatocytes and hematopoietic stem cells after busulfan and Ad:uPA pre-conditioning. Four months after transplantation the average human liver repopulation exceeded 80% and hematopoietic chimerism also was high (40–80% in bone marrow). Importantly, human macrophages (Kupffer cells) were present in the chimeric livers. Double-chimeric FRGN mice will serve as a new model for disease processes that involve interactions between hepatocytes and hematolymphoid cells.
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Affiliation(s)
| | - J Bial
- Yecuris Corp., Tigard, OR, USA
| | | | - G Bial
- Yecuris Corp., Tigard, OR, USA
| | | | - D L Greiner
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA
| | - M A Brehm
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA
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25
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Keen L, Khan M, Clifford L, Harrell PT, Latimer WW. Injection and non-injection drug use and infectious disease in Baltimore City: differences by race. Addict Behav 2014; 39:1325-8. [PMID: 24837755 PMCID: PMC4078397 DOI: 10.1016/j.addbeh.2014.04.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 04/24/2014] [Accepted: 04/28/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE The current study examines differences in the prevalence of biologically-confirmed hepatitis C virus (HCV), HIV, and coinfection between Black and White adult cocaine/heroin users across three drug use subgroups identified in previous research (Harrell et al., 2012): non-injection smoking crack/nasal heroin users, heroin injectors, and polydrug injectors. RESULTS 59% of the 482 participants in the study were male. Significant race differences emerged between drug use subgroup memberships. Non-injection smoking crack/nasal heroin users were predominantly Black (75%), while heroin injectors and polydrug injectors were predominantly White (69% and 72%, respectively). Polydrug injectors accounted for nearly three quarters of the HCV positive diagnoses in Whites. Though HIV disease status, stratified by race, did not differ significantly between drug use subgroups, the non-injection smoking crack/nasal heroin subgroup contained over half of the HIV positive diagnoses in the sample and was predominantly Black. Despite much lower rates of injection, Blacks (8%) had a higher prevalence of coinfection than Whites (3%; X(2) (2)=6.18, p=.015). CONCLUSIONS The current findings are consistent with trends in the recent HIV transmission statistics where sexual activity has overtaken injection drug use as a HIV risk factor. The current findings also provide further support to the notion of injection drug use as an exceedingly high-risk behavior for HCV and coinfection, specifically those who are polysubstance injectors.
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Affiliation(s)
- Larry Keen
- Department of Clinical and Health Psychology, University of Florida, United States.
| | - Maria Khan
- Department of Epidemiology, University of Florida, United States
| | - Lisa Clifford
- Department of Clinical and Health Psychology, University of Florida, United States
| | - Paul T Harrell
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, United States
| | - William W Latimer
- Department of Clinical and Health Psychology, University of Florida, United States
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26
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Pearlman BL, Lim TH. You're not the one: treating subjects co-infected with hepatitis C genotypes 2 and 3 and human immunodeficiency virus. Dig Dis Sci 2014; 59:1681-3. [PMID: 25002310 DOI: 10.1007/s10620-014-3270-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Accepted: 06/25/2014] [Indexed: 12/09/2022]
Affiliation(s)
- Brian L Pearlman
- Center for Hepatitis C, Atlanta Medical Center, 285 Boulevard NE Suite 525, Atlanta, GA, 30312, USA,
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27
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Ramezani A, Amirmoezi R, Volk JE, Aghakhani A, Zarinfar N, McFarland W, Banifazl M, Mostafavi E, Eslamifar A, Sofian M. HCV, HBV, and HIV seroprevalence, coinfections, and related behaviors among male injection drug users in Arak, Iran. AIDS Care 2014; 26:1122-6. [PMID: 24499303 DOI: 10.1080/09540121.2014.882485] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This study explored the prevalence and related risk behaviors for hepatitis C (HCV), hepatitis B (HBV), and human immunodeficiency virus (HIV) among a sample of male injection drug users (IDUs) in Arak, Iran. One hundred male IDUs attending methadone maintenance clinics between April and September 2012 were enrolled and evaluated for HCV, HBV, and HIV infection. The majority of study participants (56%) had evidence of HCV exposure, 6% had evidence of HBV, and 19% were HIV-infected. Coinfections were frequent; 15% had evidence of HIV and HCV, 6% had evidence of HBV and HCV, and 5% had serologic markers for all three infections. Most (84%) were susceptible to HBV infection. A history of any syringe sharing (54%) and syringe sharing in prison (25%) were common. In bivariate analyses, a history of any syringe sharing and syringe sharing in prison were both associated with all three viral infections. The high prevalence of HCV, HBV, HIV, and coinfections among IDU in Arak is concerning and indicates rapid disease spread outside of Iran's main urban centers. Prevention efforts should expand vaccination for IDUs who are nonimmune to HBV and continue to target syringe sharing with efforts such as needle exchange programs, including inside prisons.
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Affiliation(s)
- Amitis Ramezani
- a Clinical Research Department , Pasteur Institute of Iran , Tehran , Iran
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28
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Streeck H, Rockstroh JK. Challenges in the treatment of HIV and HCV coinfection. Expert Rev Clin Immunol 2014; 2:811-22. [DOI: 10.1586/1744666x.2.5.811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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29
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Grompe M, Strom S. Mice with human livers. Gastroenterology 2013; 145:1209-14. [PMID: 24042096 DOI: 10.1053/j.gastro.2013.09.009] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 09/04/2013] [Accepted: 09/04/2013] [Indexed: 12/28/2022]
Abstract
Animal models are used to study many aspects of human disease and to test therapeutic interventions. However, some very important features of human biology cannot be replicated in animals, even in nonhuman primates or transgenic rodents engineered with human genes. Most human microbial pathogens do not infect animals and the metabolism of many xenobiotics is different between human beings and animals. The advent of transgenic immune-deficient mice has made it possible to generate chimeric animals harboring human tissues and cells, including hepatocytes. The liver plays a central role in many human-specific biological processes and mice with humanized livers can be used to model human metabolism, liver injury, gene regulation, drug toxicity, and hepatotropic infections.
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Affiliation(s)
- Markus Grompe
- Oregon Stem Cell Center, Department of Pediatrics, Oregon Health & Science University, Portland, Oregon.
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30
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Ioannou GN, Scott JD, Yang Y, Green PK, Beste LA. Rates and predictors of response to anti-viral treatment for hepatitis C virus in HIV/HCV co-infection in a nationwide study of 619 patients. Aliment Pharmacol Ther 2013; 38:1373-84. [PMID: 24127691 DOI: 10.1111/apt.12524] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Revised: 08/19/2013] [Accepted: 09/18/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND The effectiveness of anti-viral treatment for hepatitis C virus (HCV) in HIV/HCV co-infected patients in 'real world', clinical practice is unclear. AIMS To determine the rates and predictors of sustained virological response (SVR) to anti-viral treatment for HCV with pegylated interferon (PEG-IFN) and ribavirin in HIV/HCV co-infected patients. METHODS We identified all HIV/HCV co-infected patients who received anti-viral treatment with PEG-IFN and ribavirin in the Veterans Affairs healthcare system nationally between 2002 and 2009 (n = 665). RESULTS Sustained virological response was achieved in 21.6% overall, 16.7% among patients with genotype 1 HCV (n = 491) and 44% among patients with genotype 2 or 3 HCV (n = 116). Among genotype 1-infected patients, characteristics that were negatively associated with SVR independently included baseline HCV viral load >2 million IU/mL [adjusted odds ratio (AOR) 0.41, 95% CI 0.2-0.7], Black race [AOR 0.56 (0.3-0.96)], diabetes [AOR 0.42 (0.2-0.9)], baseline anaemia [AOR 0.42 (0.2-0.97)], serum aspartate aminotransferase/alanine aminotransferase ratio ≥1.2 [AOR 0.48 (0.2-0.97)] and use of zidovudine [AOR 0.41 (0.2-0.9)]; characteristics positively associated with SVR included a starting dose of ribavirin ≥1000-1200 mg/day [AOR 2.0 (1.1-3.7)] and erythropoietin use during treatment [AOR 2.9 (1.6-5.0)]. Among genotype 2 or 3 infected patients, only erythropoietin use was an independent predictor of SVR [AOR 3.1 (1.2-7.8)], while a starting dose of ribavirin >800 mg/day was not associated with SVR. CONCLUSIONS Sustained virological response rates achieved with PEG-IFN and ribavirin in HIV/HCV co-infected patients are low in clinical practice. The use of erythropoietin was the most important, modifiable factor associated with SVR.
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Affiliation(s)
- G N Ioannou
- Division of Gastroenterology, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA; Health Services Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA; Divisions of Gastroenterology, University of Washington, Seattle, WA, USA
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31
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Juniastuti, Utsumi T, Nasronudin, Alimsardjono L, Amin M, Adianti M, Yano Y, Soetjipto, Hayashi Y, Hotta H, Lusida MI. High rate of seronegative HCV infection in HIV-positive patients. Biomed Rep 2013; 2:79-84. [PMID: 24649073 DOI: 10.3892/br.2013.188] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Accepted: 10/18/2013] [Indexed: 01/29/2023] Open
Abstract
Co-infection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) is a significant global health problem. The two viruses are transmitted with high efficacy via blood-to-blood contact, mainly intravenous drug use (IVDU), whereas HCV is less easily transmitted sexually. Antibody testing is the main screening method for HCV infection, although it may not be the optimal option for HIV infection. The aim of this study was to investigate HCV infection in HIV-positive patients, with and without a detectable anti-HCV antibody response. A total of 187 plasma samples were obtained from HIV-positive patients in Surabaya, Indonesia and examined for anti-HCV [HCV enzyme immunoassay (EIA) 3.0], HCV genotype/subtype [reverse transcription-polymerase chain reaction (RT-PCR) using primers targeting a part of NS5B/5'UTR followed by sequencing] and HCV viral load (quantitative RT-PCR). A total of 119 patients (63.6%) were found to be anti-HCV-positive and, among these, HCV RNA was detected in 73 (61.3%), with HCV-1a as the predominant subtype (31.5%). Of the 68 anti-HCV-negative samples, HCV RNA was detected in 26/68 (38.2%) mostly as the HCV-3a subtype (50%). High HCV viral loads were more common among the HCV-seropositive patients. The HCV-seropositive samples with detected HCV RNA were mostly obtained from HIV-positive patients with parenteral transmission (IVDU) (76.7%); however, the HCV-seronegative samples with detected HCV RNA were mostly from patients who had acquired HCV through heterosexual transmission (61.5%). In conclusion, HIV-positive patients were at high risk of becoming co-infected with HCV and several remained HCV-seronegative. Furthermore, there may exist differences in HCV seropositivity and subtypes between HIV-positive patients who acquired HCV sexually and those who acquired HCV parenterally.
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Affiliation(s)
- Juniastuti
- Department of Microbiology, School of Medicine, Airlangga University, Surabaya, East Java 60131, Indonesia ; Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Surabaya, East Java 60115, Indonesia
| | - Takako Utsumi
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Surabaya, East Java 60115, Indonesia ; Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Hyogo 6500017, Japan
| | - Nasronudin
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Surabaya, East Java 60115, Indonesia ; Institute of Tropical Disease, Airlangga University, Surabaya, East Java 60115, Indonesia ; Department of Internal Medicine, Dr Soetomo General Hospital, Surabaya, East Java 60131, Indonesia
| | - Lindawati Alimsardjono
- Department of Microbiology, School of Medicine, Airlangga University, Surabaya, East Java 60131, Indonesia
| | - Mochamad Amin
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Surabaya, East Java 60115, Indonesia ; Institute of Tropical Disease, Airlangga University, Surabaya, East Java 60115, Indonesia
| | - Myrna Adianti
- Institute of Tropical Disease, Airlangga University, Surabaya, East Java 60115, Indonesia
| | - Yoshihiko Yano
- Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Hyogo 6500017, Japan
| | - Soetjipto
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Surabaya, East Java 60115, Indonesia ; Department of Biochemistry, School of Medicine, Airlangga University, Surabaya, East Java 60131, Indonesia
| | - Yoshitake Hayashi
- Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Hyogo 6500017, Japan
| | - Hak Hotta
- Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Hyogo 6500017, Japan
| | - Maria Inge Lusida
- Department of Microbiology, School of Medicine, Airlangga University, Surabaya, East Java 60131, Indonesia ; Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Surabaya, East Java 60115, Indonesia ; Institute of Tropical Disease, Airlangga University, Surabaya, East Java 60115, Indonesia
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32
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Jonckheere S, Vincent A, Belkhir L, Wilmes D, Vandercam B, Yombi JC. Adherence to screening guidelines for hepatitis C among HIV-positive patients. AIDS Patient Care STDS 2013; 27:317-9. [PMID: 23682636 DOI: 10.1089/apc.2013.0096] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Sylvie Jonckheere
- Centre de Réference SIDA, Université Catholique de Louvain, Bruxelles, Belgium
| | - Anne Vincent
- Centre de Réference SIDA, Université Catholique de Louvain, Bruxelles, Belgium
| | - Leila Belkhir
- Centre de Réference SIDA, Université Catholique de Louvain, Bruxelles, Belgium
| | - Dunja Wilmes
- Centre de Réference SIDA, Université Catholique de Louvain, Bruxelles, Belgium
| | - Bernard Vandercam
- Centre de Réference SIDA, Université Catholique de Louvain, Bruxelles, Belgium
| | - Jean Cyr Yombi
- Centre de Réference SIDA, Université Catholique de Louvain, Bruxelles, Belgium
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Sexual risk behavior and risk reduction beliefs among HIV-positive young men who have sex with men. AIDS Behav 2013; 17:1515-23. [PMID: 22350830 DOI: 10.1007/s10461-012-0155-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
With young men who have sex with men (YMSM) continuing to be disproportionately affected by the HIV/AIDS epidemic in the U.S., secondary prevention efforts with this population take on increasing significance. We surveyed 200 HIV-positive YMSM (ages 16-24, 66% Black, 18% Latino, 7% White, 7% Multiracial/Other) recruited from 14 HIV primary care sites to examine associations of unprotected anal intercourse (UAI) and partner HIV status with endorsement of serosorting, sexual positioning, and viral load beliefs. Proportions of participants engaging in UAI one or more times during the past three months were consistent across type of UAI (insertive or receptive) and partner status. Belief that an undetectable viral load reduces infectiousness was significantly associated with insertive UAI (p < .05) and receptive UAI (p < .05) with HIV-negative or unknown status partners and receptive UAI with HIV-positive partners (p < .01). Endorsement of belief in serosorting was significantly associated with receptive UAI (p < .01) and insertive UAI (p < .05) with HIV-positive male partners. Implications for sexual behavior and risk reduction beliefs in this population are discussed.
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34
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Zhao YS, Su SI, Lv CX, Zhang XF, Lin L, Sun XG, Lin B, Fu JH. Seroprevalence of hepatitis C, hepatitis B virus and syphilis in HIV-1 infected patients in Shandong, China. Int J STD AIDS 2013; 23:639-43. [PMID: 23033517 DOI: 10.1258/ijsa.2012.011411] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
To determine the seroprevalence of hepatitis C virus (HCV), hepatitis B virus (HBV) and syphilis in HIV-1-infected patients and related risk factors in Shandong province, China, we tested all eligible participants between 2000 and 2010 for the presence of anti-HCV antibody, hepatitis B surface antigen (HBsAg) and non-treponemal antibodies for syphilis after informed consent. Among 2087 HIV-infected patients, anti-HCV antibody was present in 41.2%, HBsAg in 12.6% and rapid plasma reagin (RPR) reactivity in 19.6%. In the multivariate logistic regression model, male gender (adjusted odds ratio [aOR] = 1.41), minority ethnicity (aOR = 1.72), syphilis infection (aOR = 1.40), former paid blood donors (aOR = 3.36), blood transfusion recipients (aOR = 2.91) and injection drug users (aOR = 1.98) were significantly associated with HCV infection. HCV infection (aOR = 1.40) and being men who have sex with men (aOR = 2.38) were significantly associated with syphilis infection. Co-infection with HCV, HBV and syphilis was observed frequently in all described subgroups of HIV infection. The results of this study suggest that it is necessary to screen for these viruses and syphilis in all Chinese HIV-infected patients.
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Affiliation(s)
- Y S Zhao
- Shandong Academy of Medicine of Sciences, Jinan, China
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35
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Feuth T, Arends JE, Fransen JH, Nanlohy NM, van Erpecum KJ, Siersema PD, Hoepelman AIM, van Baarle D. Complementary role of HCV and HIV in T-cell activation and exhaustion in HIV/HCV coinfection. PLoS One 2013; 8:e59302. [PMID: 23555014 PMCID: PMC3598709 DOI: 10.1371/journal.pone.0059302] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Accepted: 02/13/2013] [Indexed: 11/18/2022] Open
Abstract
Objectives To investigate whether T-cell activation and exhaustion is linked to HCV- and HIV disease parameters in HIV/HCV infected individuals, we studied T-cell characteristics in HIV/HCV coinfected patients and controls. Methods 14 HIV/HCV coinfected, 19 HCV monoinfected, 10 HIV monoinfected patients and 15 healthy controls were included in this cross-sectional study. Differences in expression of activation and exhaustion markers (HLA-DR, CD38, PD-1, Tim-3 and Fas) and phenotypic markers on CD4+ and CD8+ T-cells were analysed by flow cytometry and were related to HCV disease parameters (HCV-viremia, ALT and liver fibrosis). Results Frequencies of activated CD4+ and CD8+ T-cells were higher in HIV/HCV-coinfected compared to healthy controls and HCV or HIV mono-infected individuals. Coinfected patients also showed high expression of the exhaustion marker PD-1 and death receptor Fas. In contrast, the exhaustion marker Tim-3 was only elevated in HIV-monoinfected patients. T-cell activation and exhaustion were correlated with HCV-RNA, suggesting that viral antigen influences T-cell activation and exhaustion. Interestingly, increased percentages of effector CD8+ T-cells were found in patients with severe (F3–F4) liver fibrosis compared to those with no to minimal fibrosis (F0–F2). Conclusions HIV/HCV coinfected patients display a high level of T-cell activation and exhaustion in the peripheral blood. Our data suggest that T-cell activation and exhaustion are influenced by the level of HCV viremia. Furthermore, high percentages of cytotoxic/effector CD8+ T-cells are associated with liver fibrosis in both HCV monoinfected and HIV/HCV coinfected patients.
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Affiliation(s)
- Thijs Feuth
- Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Joop E. Arends
- Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Justin H. Fransen
- Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
- Department of Immunology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Nening M. Nanlohy
- Department of Immunology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Karel J. van Erpecum
- Department of Gastroenterology and Hepatology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Peter D. Siersema
- Department of Gastroenterology and Hepatology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Andy I. M. Hoepelman
- Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Debbie van Baarle
- Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
- Department of Immunology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
- * E-mail:
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Castro Sanchez AY, Aerts M, Shkedy Z, Vickerman P, Faggiano F, Salamina G, Hens N. A mathematical model for HIV and hepatitis C co-infection and its assessment from a statistical perspective. Epidemics 2013; 5:56-66. [PMID: 23438431 DOI: 10.1016/j.epidem.2013.01.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 12/24/2012] [Accepted: 01/02/2013] [Indexed: 02/05/2023] Open
Abstract
The hepatitis C virus (HCV) and the human immunodeficiency virus (HIV) are a clear threat for public health, with high prevalences especially in high risk groups such as injecting drug users. People with HIV infection who are also infected by HCV suffer from a more rapid progression to HCV-related liver disease and have an increased risk for cirrhosis and liver cancer. Quantifying the impact of HIV and HCV co-infection is therefore of great importance. We propose a new joint mathematical model accounting for co-infection with the two viruses in the context of injecting drug users (IDUs). Statistical concepts and methods are used to assess the model from a statistical perspective, in order to get further insights in: (i) the comparison and selection of optional model components, (ii) the unknown values of the numerous model parameters, (iii) the parameters to which the model is most 'sensitive' and (iv) the combinations or patterns of values in the high-dimensional parameter space which are most supported by the data. Data from a longitudinal study of heroin users in Italy are used to illustrate the application of the proposed joint model and its statistical assessment. The parameters associated with contact rates (sharing syringes) and the transmission rates per syringe-sharing event are shown to play a major role.
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Affiliation(s)
- Amparo Yovanna Castro Sanchez
- Interuniversity Institute for Biostatistics and statistical Bioinformatics, Hasselt University, Agoralaan 1, B3590 Diepenbeek, Belgium.
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Hartling HJ, Gaardbo JC, Ronit A, Knudsen LS, Ullum H, Vainer B, Clausen MR, Skogstrand K, Gerstoft J, Nielsen SD. CD4⁺ and CD8⁺ regulatory T cells (Tregs) are elevated and display an active phenotype in patients with chronic HCV mono-infection and HIV/HCV co-infection. Scand J Immunol 2012; 76:294-305. [PMID: 22671952 DOI: 10.1111/j.1365-3083.2012.02725.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The aim of this study was to examine regulatory T cells (Tregs) in peripheral blood and liver tissue in patients with chronic hepatitis C virus (HCV) mono-infection and in patients with HIV/HCV co-infection. In a cross-sectional study were included 51 patients with chronic HCV infection, 24 patients with HIV/HCV co-infection and 24 healthy individuals. CD4⁺ and CD8⁺ Tregs were determined using flow cytometry. Fibrosis was examined by transient elastography. Inflammation, fibrosis and Tregs were determined in liver biopsies from 12 patients. Increased frequency of CD4⁺ and CD8⁺ Tregs was found in HIV/HCV co-infected patients [median: 6.4% (IQR: 5.7-6.9) and 1.0% (0.7-1.2), respectively] compared to HCV mono-infected patients [5.6% (4.2-6.3), P = 0.01 and 0.5% (0.3-0.7), P < 0.001, respectively]. Furthermore, HCV mono-infected patients had increased frequencies of Tregs compared with healthy controls (P < 0.05). However, no associations between the frequency of Tregs and fibrosis were found. Furthermore, characterization of CD4⁺ Tregs using CD45RA demonstrated a higher frequency of activated Tregs in both HCV mono-infected and HIV/HCV co-infected patients compared with healthy controls. Finally, number of intrahepatic Tregs was associated with both peripheral CD8⁺ Tregs and intrahepatic inflammation. In conclusion, HCV mono-infected patients and particularly HIV/HCV co-infected patients have increased the frequency of CD4⁺ and CD8⁺ Tregs compared with healthy controls. Furthermore, CD4⁺ Tregs in infected patients displayed an active phenotype. Tregs were not associated with fibrosis, but a positive correlation between intrahepatic Tregs and inflammation was found. Taken together, these results suggest a role for Tregs in the pathogenesis of chronic HCV infection.
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Affiliation(s)
- H J Hartling
- Department of Infectious Diseases, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
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38
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Rockstroh JK. How important is HIV therapy for preventing liver fibrosis progression in HIV-HCV-coinfected individuals? Antivir Ther 2012; 17:1223-5. [PMID: 23052962 DOI: 10.3851/imp2432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2012] [Indexed: 01/29/2023]
Abstract
Early HIV therapy in HIV-HCV-coinfected individuals appears advisable in order to not only improve HIV outcome but also delay the natural course of liver disease. Indeed, antiretroviral-therapy-induced control of HIV infection with undetectable plasma HIV RNA levels affects HIV-HCV viral interactions and decreases liver inflammation resulting in lower fibrosis progression rates. Although these findings have influenced current revised HIV guidelines, HIV therapy is still started too late in most HCV-coinfected individuals, suggesting that, particularly in special at-risk patient populations, such as intravenous drug users, barriers to treatment uptake are still existing.
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39
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Shen YZ, Wang ZY, Qi TK, Jiang XY, Song W, Tang Y, Wang JR, Liu L, Zhang RF, Zheng YF, Dai ZS, Lu HZ. Serological survey of viral hepatitis markers among newly diagnosed patients with HIV/AIDS in China. HIV Med 2012; 14:167-75. [DOI: 10.1111/j.1468-1293.2012.01048.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2012] [Indexed: 01/29/2023]
Affiliation(s)
- YZ Shen
- Department of Infectious Diseases; Shanghai Public Health Clinical Center; Fudan University; Shanghai; China
| | - ZY Wang
- Department of Infectious Diseases; Shanghai Public Health Clinical Center; Fudan University; Shanghai; China
| | - TK Qi
- Department of Infectious Diseases; Shanghai Public Health Clinical Center; Fudan University; Shanghai; China
| | - XY Jiang
- Department of Infectious Diseases; Shanghai Public Health Clinical Center; Fudan University; Shanghai; China
| | - W Song
- Department of Infectious Diseases; Shanghai Public Health Clinical Center; Fudan University; Shanghai; China
| | - Y Tang
- Department of Infectious Diseases; Shanghai Public Health Clinical Center; Fudan University; Shanghai; China
| | - JR Wang
- Department of Infectious Diseases; Shanghai Public Health Clinical Center; Fudan University; Shanghai; China
| | - L Liu
- Department of Infectious Diseases; Shanghai Public Health Clinical Center; Fudan University; Shanghai; China
| | - RF Zhang
- Department of Infectious Diseases; Shanghai Public Health Clinical Center; Fudan University; Shanghai; China
| | - YF Zheng
- Department of Infectious Diseases; Shanghai Public Health Clinical Center; Fudan University; Shanghai; China
| | - ZS Dai
- Department of Infectious Diseases; Shanghai Public Health Clinical Center; Fudan University; Shanghai; China
| | - HZ Lu
- Department of Infectious Diseases; Shanghai Public Health Clinical Center; Fudan University; Shanghai; China
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40
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McCarthy M, Ortega MR. Neurological complications of hepatitis C infection. Curr Neurol Neurosci Rep 2012; 12:642-54. [PMID: 22991069 DOI: 10.1007/s11910-012-0311-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Though well-known as a cause of liver disease, Hepatitis C virus infection is emerging as a cause of a variety of peripheral and central nervous system disorders. The virus causes chronic persistent infection with complex immune responses in the majority of individuals. Viral infection may have the potential to generate neurological illness through direct infection of neural cells or through immune-mediated mechanisms, including enhancement of autoimmune responses. Moreover, the mainstay of antiviral treatment of hepatitis C infection, interferon-alpha, is itself associated with neurological morbidity. Thus neurologists are increasingly faced with diagnosing or even predicting a wide spectrum of neurological complications of hepatitis C infection and/or its treatment.
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Affiliation(s)
- Micheline McCarthy
- Neurology (127), Bruce Carter Veterans Affairs Medical Center, 1201 NW 16th Street, Miami, FL 33125, USA.
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41
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Meissner EG, Suffredini AF, Kottilil S. Opportunities in proteomics to understand hepatitis C and HIV coinfection. Future Virol 2012; 7:759-765. [PMID: 23105947 PMCID: PMC3480018 DOI: 10.2217/fvl.12.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Antiretroviral therapy has significantly reduced morbidity and mortality associated with HIV infection. However, coinfection with HCV results in a more complicated disease course for both infections. HIV infection dramatically impacts the natural history of chronic liver disease due to HCV. Coinfected patients not on antiretroviral therapy for HIV develop liver fibrosis and cirrhosis at a faster rate, clear acute infection less commonly and respond to IFN-α-based therapy for chronic infection less often than HCV-monoinfected patients. The interaction between these two viruses, the immune system and the fibrotic machinery of the liver remains incompletely understood. In this review, we discuss recent advances in proteomics as applied to HCV and HIV and highlight issues in coinfection that are amenable to further discovery through proteomic approaches. We focus on clinical predictors of liver fibrosis and treatment outcome as these have the greatest potential clinical applicability.
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Affiliation(s)
- Eric G Meissner
- Laboratory of Immunoregulation, National Institute of Allergy & Infectious Diseases, Bethesda, MD 20892, USA
| | - Anthony F Suffredini
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD 20892, USA
| | - Shyamasundaran Kottilil
- Laboratory of Immunoregulation, National Institute of Allergy & Infectious Diseases, Bethesda, MD 20892, USA
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Orthotopic liver transplantation in human-immunodeficiency-virus-positive patients in Germany. AIDS Res Treat 2012; 2012:197501. [PMID: 22900154 PMCID: PMC3413997 DOI: 10.1155/2012/197501] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Accepted: 05/09/2012] [Indexed: 01/02/2023] Open
Abstract
Objectives. This summary evaluates the outcomes of orthotopic liver transplantation (OLT) of HIV-positive patients in Germany. Methods. Retrospective chart analysis of HIV-positive patients, who had been liver-transplanted in Germany between July 1997 and July 2011. Results. 38 transplantations were performed in 32 patients at 9 German transplant centres. The reasons for OLT were end-stage liver disease (ESLD) and/or liver failure due to hepatitis C (HCV) (n = 19), hepatitis B (HBV) (n = 10), multiple viral infections of the liver (n = 2) and Budd-Chiari-Syndrome. In July 2011 19/32 (60%) of the transplanted patients were still alive with a median survival of 61 months (IQR (interquartile range): 41–86 months). 6 patients had died in the early post-transplantation period from septicaemia (n = 4), primary graft dysfunction (n = 1), and intrathoracal hemorrhage (n = 1). Later on 7 patients had died from septicaemia (n = 2), delayed graft failure (n = 2), recurrent HCC (n = 2), and renal failure (n = 1). Recurrent HBV infection was efficiently prevented in 11/12 patients; HCV reinfection occurred in all patients and contributed considerably to the overall mortality. Conclusions. Overall OLT is a feasible approach in HIV-infected patients with acceptable survival rates in Germany. Reinfection with HCV still remains a major clinical challenge in HIV/HCV coinfection after OLT.
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Liu X, He N, Fu Z, Duan S, Gao M, Zhang ZF. Plasma Hepatitis C Virus Viral Load Among Hepatitis C Virus Mono-Infected and HCV/HIV Co-Infected Individuals in Yunnan Province,China. HEPATITIS MONTHLY 2012; 12:453-9. [PMID: 23008726 PMCID: PMC3437457 DOI: 10.5812/hepatmon.6160] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 05/22/2012] [Accepted: 06/16/2012] [Indexed: 12/11/2022]
Abstract
BACKGROUND Hepatitis C virus (HCV)/human immunodeficiency virus (HIV) co-infection has become a serious public health problem especially in high risk groups such as injection drug users in China. However, the impact of HIV infection and antiretroviral therapy (ART) on HCV viral load which is usually regarded as a predictor of liver disease progress had not been well studied in this country. OBJECTIVES To explore correlations of HIV co-infection and ART with plasma HCV load among HCV-infected patients in an ethnic minority area in Yunnan Province, China. PATIENTS AND METHODS HCV/HIV co-infected patients and HCV mono-infected controls were examined and compared for plasma HCV RNA and related risk factors. RESULTS A total of 145 HCV/HIV co-infected patients and 25 HCV mono-infected controls were studied. The majority of the participants were male, belonged to an ethnic minority and were younger than 45 years old. HCV viral suppression rate with undetectable plasma HCV viral load was 28.3% in the HCV/HIV co-infected patients, 36% among HCV mono-infected controls and 29.4% overall. ART-prescribed HCV/HIV co-infected patients had significantly higher HCV viral loads (IQR: (3.80-6.44)*log(10) copies ml-1) than those naïve to ART (IQR: (undetectable-6.41)*log(10) copies ml-1) and HCV mono-infected patients (IQR: (undetectable-5.44)*log(10) copies ml-1). Men, from the Dai minority and those with more than six years education, were also shown to have a higher plasma HCV viral load,according to multiple logistic regression analysis. CONCLUSIONS ART potentially increases the plasma HCV viral load among HCV/HIV coinfected patients in an ethnic minority area in China. Future large scale prospective cohort studies are needed to address the controversy associated between HIV co-infection and the natural history of HCV.
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Affiliation(s)
- Xing Liu
- Department of Epidemiology, School of Public Health, Fudan University, The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai, China
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, USA
| | - Na He
- Department of Epidemiology, School of Public Health, Fudan University, The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai, China
- Corresponding author: Na He, Department of Epidemiology, School of Public Health, Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai 200032, China. Tel.: +86-2154237519, Fax: +86-2154237519, E-mail:
| | - Zhuohua Fu
- Department of Epidemiology, School of Public Health, Fudan University, The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai, China
| | - Song Duan
- Dehong Prefecture Center for Disease Control and Prevention, Yunnan Province, China
| | - Meiyang Gao
- Department of Epidemiology, School of Public Health, Fudan University, The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai, China
| | - Zuo Feng Zhang
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, USA
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44
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Boesecke C, Rockstroh JK. [Treatment of chronic hepatitis C in HIV coinfection]. MMW Fortschr Med 2012; 154 Suppl 1:42-44. [PMID: 22916601 DOI: 10.1007/s15006-012-0626-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Abstract
Hepatitis C virus (HCV) is an enveloped, positive-strand RNA virus of the family Flaviviridae that primarily infects hepatocytes, causing acute and chronic liver disease. HCV is also associated with a variety of extrahepatic symptoms including central nervous system (CNS) abnormalities, cognitive dysfunction, fatigue and depression. These symptoms do not correlate with the severity of liver disease and are independent of hepatic encephalopathy. HCV RNA has been associated with CNS tissue, and reports of viral sequence diversity between brain and liver tissue suggest independent viral evolution in the CNS and liver. This review will explore the data supporting HCV infection of the CNS and how this fits into our current understanding of HCV pathogenesis.
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Affiliation(s)
- N F Fletcher
- Hepatitis C Research Group, Institute for Biomedical Research, University of Birmingham, Birmingham, B15 2TT, UK.
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46
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Rizza SA, Challagundla KB, Natesampillai S, Bren GD, Sykora J, Walczak H, Badley AD. TRAIL dependent fratricidal killing of gp120 primed hepatocytes by HCV core expressing hepatocytes. PLoS One 2011; 6:e27171. [PMID: 22110611 PMCID: PMC3215710 DOI: 10.1371/journal.pone.0027171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Accepted: 10/11/2011] [Indexed: 02/07/2023] Open
Abstract
The mechanism by which HIV and HCV cooperatively accelerate hepatocyte damage is not clearly understood; however, each virus affects the TRAIL: TRAIL-receptor system. We, therefore, questioned whether the independent effects of HCV and HIV combine to synergistically result in TRAIL dependent hepatocyte killing. We describe that Huh7 hepatocytes treated with HIV gp120 results in both increase TRAIL-R2 expression and an acquired sensitivity to TRAIL mediated killing. Moreover HCV infection and HCV core expression alone in Huh7 cells upregulates TRAIL. Co-incubation of HIV gp120 primed hepatocytes with HCV core expressing hepatocytes results in the selective death of the HIV gp120 primed hepatocytes that is selectively blocked by TRAIL-R2-Fc fusion protein. Liver biopsies from HIV mono-infected patients have increased TRAIL-R2; biopsies from HCV infected patients have increased TRAIL, while co-infected liver biopsies have increased PARP cleavage within hepatocytes indicating enhanced apoptosis. These findings suggest a pathogenic model to understand why HIV/HCV co-infection accelerates liver injury.
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Affiliation(s)
- Stacey A. Rizza
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Kishore B. Challagundla
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Sekar Natesampillai
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Gary D. Bren
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Jaromir Sykora
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Henning Walczak
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Andrew D. Badley
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, United States of America
- * E-mail:
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Antonello VS, Tovo CV, Kliemann DA, Santos BR, Zaltron VF. [Evaluation of APRI score in liver disease following the introduction of antiretroviral therapy in HIV and HCV coinfected versus HIV monoinfected patients]. Rev Soc Bras Med Trop 2011; 43:678-81. [PMID: 21181022 DOI: 10.1590/s0037-86822010000600015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2010] [Accepted: 09/03/2010] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION The impact of highly active antiretroviral therapy (HAART) on hepatic fibrosis progression in HIV and hepatitis C virus coinfected patients is not completely understood. Noninvasive hepatic fibrosis markers show great promise in determining liver fibrosis staging and monitoring disease progression. METHODS Twenty-four patients divided equally into two groups: 12 HIV-monoinfected and 12 with HIV/HCV coinfected patients, were followed from July 2008 to August 2009, after initiating HAART, with clinical, epidemiological and laboratorial assessments every 3 months and calculation of the aspartate aminotransferase to platelet ratio index (APRI). This study aimed to compare the progression of APRI, a noninvasive hepatic fibrosis marker, among populations with HIV and HIV/HCV coinfection. RESULTS No differences were observed between the groups regarding age, sex, measurement of CD4 and HIV viral load in all consultations, type of HAART and APRI before initiating HAART. Coinfected patients showed a significantly higher APRI than the monoinfected group in month 3 (0.57 ± 0.31 x 0.27 ± 0.105, p = 0.02) and 6 (0.93 ± 0.79 x 0.28 ± 0.11, p = 0.04). CONCLUSIONS In the present study, HAART was associated with APRI increases over six months follow-up in HIV/HCV coinfected patients, suggesting that these may be experiencing cumulative hepatotoxicity and immune reconstitution inflammatory syndrome after initiating antiretroviral drugs.
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Impact of human immunodeficiency virus coinfection on the progression of mother-to-child transmitted hepatitis C virus infection. Pediatr Infect Dis J 2011; 30:801-4. [PMID: 21772231 DOI: 10.1097/inf.0b013e3182196ab4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Data on mother-to-child transmitted human immunodeficiency virus/hepatitis C virus (HIV/HCV) coinfection are scarce. A prospective observational study with a cohort of 70 HCV-infected children (13 of whom were HIV/HCV-coinfected; mean follow-up: 7.3 years) is presented. In our series, surrogate markers of disease progression (HCV viremia, maximum alanine aminotransferase values, and spontaneous HCV infection clearance) suggest that the evolution of liver disease in HIV/HCV-coinfected pediatric patients is more aggressive than it is in HCV-only infected children.
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50
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Dillon AA, Farrell G, Hegarty JE, O'Grady JG, Norris S, Bergin C. The advent of successful organ transplantation in the Irish HIV positive cohort. Ir J Med Sci 2011; 181:49-52. [PMID: 21853387 DOI: 10.1007/s11845-011-0746-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2009] [Accepted: 08/03/2011] [Indexed: 10/17/2022]
Abstract
BACKGROUND Liver disease is an increasing cause of morbidity and mortality in Human immunodeficiency virus (HIV) positive patients. AIM To describe the first cases of organ transplantation in HIV positive patients in Ireland. METHOD We report the Irish patients with HIV who received liver transplantation and performed a chart review. RESULT Two patients received liver transplantation for end stage liver disease caused by Hepatitis C, with survival at 2 years of 100%. CONCLUSION Liver transplantation is a feasible treatment for patients with HIV and end stage liver disease. The success of transplantation in the HIV positive population should encourage the provision of other medical and surgical interventions previously not offered to patients with HIV.
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Affiliation(s)
- A A Dillon
- Department of Genitourinary Medicine and Infectious Diseases, St. James's Hospital, James's Street, Dublin 8, Ireland.
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