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Pansue K, Promsena P, Songtaweesin WN, Moonwong J, Ryan J, Kawichai S, Thanapirom K, Puthanakit T. High prevalence of hepatitis C virus infection among adolescents and young adults attending HIV and sexual health clinics. Int J STD AIDS 2024:9564624241302231. [PMID: 39693642 DOI: 10.1177/09564624241302231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2024]
Abstract
BACKGROUND The prevalence of hepatitis C virus (HCV) infection among Thai adults is 0.5%-1.0%. This study aims to determine the prevalence of HCV infection among adolescents and young adults (AYA) accessing HIV/sexual health clinics. METHODS A cross-sectional study was conducted among AYA aged 15-24 years attending HIV/sexual health clinics in Bangkok, Thailand. The HCV infection prevalence, defined by anti-HCV antibody positivity using rapid diagnostic tests (SD BIOSENSOR, Korea), were reported with proportions and a 95% confidence interval (CI). Multivariate logistic regression was performed to identify factors associated with HCV infection. RESULTS From March to August 2023, 300 AYAs with a median age of 21 (interquartile range 20-23) years were enrolled into the study. One-third (29.7%) were people living with HIV (PLHIV). The overall prevalence of HCV infection was 2.7% (95%CI 1.2-5.2). Prevalence was higher among PLHIV (5.6%) compared to AYA without HIV (1.4%) (p-value 0.053). The factor most significantly associated with HCV infection was people who used drugs (adjusted odds ratio 15.3, 95% CI 2.9-82.0, p-value 0.001). CONCLUSIONS History of drug use was associated with the highest HCV infection prevalence. PLHIV had a trend of higher prevalence. HCV screening in HIV/sexual health clinics is recommended for early detection, treatment, and transmission reduction.
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Affiliation(s)
- Krisanee Pansue
- Department of Pediatrics, Division of Infectious Disease, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Chulalongkorn University, Bangkok, Thailand
| | - Pathariya Promsena
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Chulalongkorn University, Bangkok, Thailand
- Search Research Foundation, Bangkok, Thailand
- Affiliated researcher at Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Wipaporn Natalie Songtaweesin
- Department of Pediatrics, Division of Infectious Disease, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Chulalongkorn University, Bangkok, Thailand
- School of Global Health, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Juthamanee Moonwong
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Chulalongkorn University, Bangkok, Thailand
| | - Juliet Ryan
- MD Program, Weill Cornell Medical College, New York, NY, USA
| | - Surinda Kawichai
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Kessarin Thanapirom
- Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Excellence Center in Liver Diseases, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Thanyawee Puthanakit
- Department of Pediatrics, Division of Infectious Disease, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Chulalongkorn University, Bangkok, Thailand
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Nilsson SS, Demant J, Thønnings S, Weis N, Westh H, Pinholt M. Dried blood spot: A diagnostic detection method for HBV, HCV and HIV nucleic acid using a single drop of blood. Diagn Microbiol Infect Dis 2024; 111:116661. [PMID: 39706101 DOI: 10.1016/j.diagmicrobio.2024.116661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Revised: 11/29/2024] [Accepted: 12/16/2024] [Indexed: 12/23/2024]
Abstract
The global strategy to eradicate Hepatitis B (HBV), Hepatitis C (HCV), and HIV by 2030 is critical due to their impact and challenges to healthcare systems. HCV is curable, but HBV and HIV are only suppressible, with a vaccine available solely for HBV. Innovative diagnostic methods are needed, especially for high-risk populations like people who inject drugs (PWID). This study validates a dried blood spot (DBS) nucleic acid amplification test (NAAT) using the Hologic Panther system for detecting HBV, HCV, and HIV. The method was used to screen among PWID in the Capital Region of Denmark. The DBS method demonstrated high sensitivity, with a 95 % limit of detection (LoD) of 2711 IU/mL for HBV, 525 IU/mL for HCV, and 4022 copies/mL for HIV. Screening of 83 PWID in Denmark revealed a 13 % prevalence of active HCV infection, offering significant benefits in settings where traditional venous access is difficult.
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Affiliation(s)
- Stephen Strunge Nilsson
- Department of Clinical Microbiology, Copenhagen University Hospital, Hvidovre, Denmark; Department of Clinical Microbiology, Copenhagen University Hospital, Herlev, Denmark.
| | - Jonas Demant
- Detpartment of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark
| | - Sara Thønnings
- Department of Clinical Microbiology, Copenhagen University Hospital, Hvidovre, Denmark
| | - Nina Weis
- Detpartment of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Henrik Westh
- Department of Clinical Microbiology, Copenhagen University Hospital, Hvidovre, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Mette Pinholt
- Department of Clinical Microbiology, Copenhagen University Hospital, Hvidovre, Denmark
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Martinello M, Carson JM, Post JJ, Finlayson R, Baker D, Read P, Shaw D, Bloch M, Doyle J, Hellard M, Filep E, Hosseini-Hooshyar S, Dore GJ, Matthews GV. Control and Elimination of Hepatitis C Virus Among People With HIV in Australia: Extended Follow-up of the CEASE Cohort (2014-2023). Open Forum Infect Dis 2024; 11:ofae665. [PMID: 39691290 PMCID: PMC11650530 DOI: 10.1093/ofid/ofae665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2024] [Accepted: 11/06/2024] [Indexed: 12/19/2024] Open
Abstract
Background Approximately 10% of people with HIV in Australia had active hepatitis C virus (HCV) infection prior to availability of government-subsidized direct-acting antiviral (DAA) therapy in 2016. This analysis evaluated progress toward HCV elimination among people with HIV in Australia between 2014 and 2023. Methods The CEASE cohort study enrolled adults with HIV with past or current HCV infection (anti-HCV antibody positive) from 14 primary and tertiary clinics. Biobehavioral, clinical, and virologic data were collected at enrollment (2014-2016), follow-up 1 (2017-2018), and follow-up 2 (2021-2023). HCV treatment uptake, outcome, and HCV RNA prevalence (current infection) were evaluated. Death and HCV reinfection incidence and risk were assessed. Results Of 402 participants, 341 (85%) had current HCV infection (RNA positive) at enrollment. Among the sample, 83% were gay and bisexual men, 13% had cirrhosis, and 80% had a history of injecting drug use (42%, past 6 months). DAA treatment was scaled up rapidly, with cumulative treatment uptake increasing from 12% in 2014 to 2015 to 92% in 2022 to 2023. HCV RNA prevalence declined from 85% (95% CI, 81%-88%) at enrollment (2014-2016) to 8% (95% CI, 6%-12%) at follow-up 1 (2017-2018) and 0.5% (95% CI, 0%-3%) at follow-up 2 (2020-2023). Sixteen reinfections occurred (incidence, 1.41 per 100 person-years; 95% CI, .81-2.29) as well as 30 deaths (incidence, 1.64 per 100 person-years; 95% CI, 1.11-2.34). HCV reinfection incidence declined over time while mortality remained stable. Conclusions Universal access and rapid DAA uptake were associated with a dramatic reduction in HCV prevalence and reinfection incidence among people with HIV to levels consistent with microelimination. Registration: NCT02102451 (ClinicalTrials.gov).
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Affiliation(s)
- Marianne Martinello
- The Kirby Institute, University of New South Wales, Sydney, Australia
- Prince of Wales Hospital, Sydney, Australia
| | - Joanne M Carson
- The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Jeffrey J Post
- Prince of Wales Hospital, Sydney, Australia
- The Albion Centre, Sydney, Australia
- School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | | | | | - Phillip Read
- The Kirby Institute, University of New South Wales, Sydney, Australia
- Kirketon Road Clinic, Sydney, Australia
| | - David Shaw
- Royal Adelaide Hospital, Adelaide, Australia
| | - Mark Bloch
- Holdsworth House Medical Practice, Sydney, Australia
| | - Joseph Doyle
- Alfred Hospital, Melbourne, Australia
- Burnet Institute, Melbourne, Australia
| | - Margaret Hellard
- Alfred Hospital, Melbourne, Australia
- Burnet Institute, Melbourne, Australia
| | - Ecaterina Filep
- The Kirby Institute, University of New South Wales, Sydney, Australia
| | | | - Gregory J Dore
- The Kirby Institute, University of New South Wales, Sydney, Australia
- St Vincent's Hospital, Sydney, Australia
| | - Gail V Matthews
- The Kirby Institute, University of New South Wales, Sydney, Australia
- St Vincent's Hospital, Sydney, Australia
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Chen Y, Zhao H, Wang Y, Liu B, Chen Z, Tao Y, Xun Y, Yang H, Liu R, Feng L, Liu X, Li H, Wang S, Liao B, Zhao D, He H, You H. The clinical prognostic risk stratification system for HIV infected hepatocellular carcinoma. Clin Res Hepatol Gastroenterol 2024; 48:102479. [PMID: 39428099 DOI: 10.1016/j.clinre.2024.102479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 09/24/2024] [Accepted: 10/10/2024] [Indexed: 10/22/2024]
Abstract
BACKGROUND Patients with human immunodeficiency virus (HIV) are more susceptible to liver cancer because of their compromised immune system. There is no specific prognostic model for HIV-infected hepatocellular carcinoma (HCC) patients. METHODS Clinical data of 85 patients with HIV-infected HCC was divided into a 7:3 ratio for training and internal validation sets, while the data of 23 patients with HIV-infected HCC was served as the external validation set. Data of 275 HIV-negative HCC patients was considered as external HIV-negative validation set. Variables associated with overall survival (OS) in the training set were used to develop the HIV-infected HCC prognosis (HIHP) model. The model was tested in the internal and external validation sets. The predictive accuracy of the model was assessed with conventional HIV-negative HCC prognostic scoring systems. RESULTS In the training set, variables independently associated with OS in multivariable analysis were organ involvement and tumor number. The HIHP model demonstrated a significant association with OS in the training set, with a median OS of 13 months for low risk, 7 months for medium risk, and 3 months for high risk (p < 0.001). The HIHP model showed a significant association with OS, and exhibited greater discriminative abilities compared to conventional HIV-negative HCC prognostic models both in the internal and external validation sets. In the external HIV-negative validation set, the HIHP model did not show better discrimination than conventional HIV-negative HCC scores. CONCLUSION The new model presented in the work provided a more accurate prognostic prediction of OS in HIV-infected HCC patients. However, the model is not applicable to patients with HIV-negative HCC.
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Affiliation(s)
- Yifan Chen
- Laboratory for Excellence in Systems Biomedicine of Pediatric Oncology, Department of Pediatric Hematology and Oncology, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China; Department of Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China
| | - Han Zhao
- Infectious Diseases Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Yao Wang
- Department of Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China
| | - Bo Liu
- Infectious Diseases Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Zhimin Chen
- Infectious Diseases Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Yu Tao
- Laboratory for Excellence in Systems Biomedicine of Pediatric Oncology, Department of Pediatric Hematology and Oncology, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Yang Xun
- Department of Basic Medicine and Biomedical Engineering, School of Medicine, Foshan University, Foshan, China
| | - Hua Yang
- Department of Basic Medicine and Biomedical Engineering, School of Medicine, Foshan University, Foshan, China
| | - Rongqiu Liu
- Laboratory for Excellence in Systems Biomedicine of Pediatric Oncology, Department of Pediatric Hematology and Oncology, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Lizhi Feng
- Infectious Diseases Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Xinhua Liu
- Infectious Diseases Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Hengjing Li
- Infectious Diseases Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Sibo Wang
- Infectious Diseases Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Baolin Liao
- Guangzhou Medical Research Institute of Infectious Diseases, Hepatology Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Dong Zhao
- Department of Liver Surgery and Organ Transplantation Center, Shenzhen Third People's Hospital, Second Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, China.
| | - Haolan He
- Infectious Diseases Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
| | - Hua You
- Laboratory for Excellence in Systems Biomedicine of Pediatric Oncology, Department of Pediatric Hematology and Oncology, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China; Department of Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China.
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5
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Tisler A, Toompere K, Bardou M, Diaz J, Orumaa M, Uusküla A. HPV-associated cancers among people living with HIV: nationwide population-based retrospective cohort study 2004-21 in Estonia. Eur J Public Health 2024; 34:1199-1204. [PMID: 39378418 PMCID: PMC11631392 DOI: 10.1093/eurpub/ckae152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2024] Open
Abstract
Cancers represent the primary cause of mortality among people living with HIV (PLWH). However, comprehensive nationwide data regarding cancer incidence remains limited. Our objective was to evaluate the incidence rates of cancers, particularly those associated with human papillomavirus (HPV), within a nationwide study cohort. Using data from the Estonian Health Insurance Fund and the National Cancer Registry from 2004 to 2021, we calculated standardized incidence ratios (SIRs) for various cancer types among PLWH to compare to the general population with special emphases on HPV-associated cancers. A total of 7011 individuals (65.7% men) diagnosed with HIV were identified. HPV-associated cancers accounted for 21.4% of all incident cancer cases among PLWH. SIRs for HPV-associated cancers were 3.7 [95% confidence interval (CI) 2.2-6.2] among men living with HIV (MLWH) and 5.7 (95% CI 4.0-7.9) among women living with HIV (WLWH). In MLWH, the highest SIRs were for penile 12.5 (95% CI 4.0-38.7), followed by oropharyngeal 3.6 (95% CI 1.7-7.6) and anal-rectal cancers 2.7 (95% CI 1.1-6.4) in comparison to the general population. In WLWH, an increased incidence of cervical (SIR = 5.8, 95% CI 3.9-8.5), oropharyngeal (SIR = 6.1, 95% CI 1.5-24.3), and anal-rectal (SIR = 3.6, 95% CI 1.2-11.2) cancers was observed. A significantly increased risk of AIDS-defining and non-AIDS-defining cancers is reported. We demonstrate a substantially heightened risk of HPV-associated cancers among PLWH compared to the general population, underscoring the imperative for intensified screening and scaled-up vaccination along with improvement in adherence to antiretroviral therapy.
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Affiliation(s)
- Anna Tisler
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Karolin Toompere
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Marc Bardou
- CIC-P INSERM 1432, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - Jose Diaz
- Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, United States
| | - Madleen Orumaa
- Department of Research, Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
| | - Anneli Uusküla
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
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Zarębska-Michaluk D, Rzymski P, Kanecki K, Tyszko P, Lewtak K, Goryński P, Genowska A, Parczewski M, Flisiak R. Hospitalizations and deaths among people coinfected with HIV and HCV. Sci Rep 2024; 14:28586. [PMID: 39562714 PMCID: PMC11576907 DOI: 10.1038/s41598-024-80289-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 11/18/2024] [Indexed: 11/21/2024] Open
Abstract
Coinfection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) remains a significant public health challenge. This retrospective, population-based study assessed the trends in hospitalization rates among patients co-infected with HCV and HIV in Poland in 2012-2022, encompassing the COVID-19 pandemic and massive influx of war refugees from Ukraine, the demographics and clinical characteristics among hospitalized patients, including in-hospital case fatality rates. Most hospitalized patients were over 40 years old (mean ± SD: 41.7 ± 8.9 years) and were men (74%). The mean annual hospitalization rate was estimated at 1.33 per 105 and was three-fold lower in the pandemic period (mean 0.51 per 105) than in the pre-pandemic era (mean 1.63 per 105). In turn, the in-hospital case-fatality rates increased during the pandemic in men (from a mean of 1.83 to 3.93) but not in women (a mean of 1.53 in both periods). There was no significant increase in hospitalization rates in 2022, during which the significant inflow of war refugees in Ukraine occurred. The epidemiological situation of people (co)infected with HIV and HCV in Poland requires further monitoring, though it did not escalate in the studied period due to the influx of war refugees from Ukraine.
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Affiliation(s)
| | - Piotr Rzymski
- Department of Environmental Medicine, Poznan University of Medical Sciences, Poznań, Poland.
| | - Krzysztof Kanecki
- Department of Social Medicine and Public Health, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Tyszko
- Department of Social Medicine and Public Health, Medical University of Warsaw, Warsaw, Poland
- Institute of Rural Health, Lublin, Poland
| | - Katarzyna Lewtak
- Department of Social Medicine and Public Health, Medical University of Warsaw, Warsaw, Poland
| | - Paweł Goryński
- National Institute of Public Health NIH - National Research Institute, Warsaw, Poland
| | - Agnieszka Genowska
- Department of Public Health, Medical University of Bialystok, Bialystok, Poland
| | - Miłosz Parczewski
- Department of Infectious, Tropical Diseases and Immune Deficiency, Pomeranian Medical University, Szczecin, Poland
| | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Białystok, Białystok, Poland
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Konishi K, Matsuo H, Shirano M. Current management and awareness of hepatitis coinfection in HIV care: A single-center retrospective study in Japan. J Infect Chemother 2024:S1341-321X(24)00304-0. [PMID: 39536987 DOI: 10.1016/j.jiac.2024.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2024] [Revised: 10/18/2024] [Accepted: 11/08/2024] [Indexed: 11/16/2024]
Abstract
BACKGROUND Liver disease remains a significant concern for people living with HIV (PLWH), especially in those with hepatitis B virus (HBV) and hepatitis C virus (HCV) coinfection. This study assessed the prevalence of viral hepatitis coinfections and evaluated the current state of hepatitis management by HIV care providers in Japan. METHODS This single-center, retrospective, observational study analyzed data from PLWH treated with antiretroviral therapy between April 1, 2023 and March 31, 2024. Data included demographics, ART regimen, hepatitis status, and screening practices of 811 PLWH treated with antiretroviral therapy. RESULTS The median age of the study population was 48 years, and 97.8 % were men. The HBV status was as follows: chronic HBV, 6.5 %; clinical remission, 34.0 %; uninfected, 30.9 %; unknown, 14.2 %. The HCV antibody positivity rate was 3.2 %. Substantial gaps in hepatitis screening and monitoring were identified. Specifically, we found inadequate rates of abdominal ultrasound examinations and HCC screening among patients with HIV and viral hepatitis coinfection. Moreover, only 71.7 % of patients chronically infected with HBV and 61.5 % with HCV underwent abdominal ultrasound examinations in the preceding 12 months-only 5.7 % and 3.8 % of the participants in these groups had had received tumor marker testing in the previous 12 months. CONCLUSION There are challenges in hepatitis and HCC screening and monitoring among patients with HIV and viral hepatitis coinfection in Japan. These findings underscore the need to improve adherence to clinical practice guidelines and implement integrated care models to enhance hepatitis management in PLWH.
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Affiliation(s)
- Keiji Konishi
- Department of Infectious Diseases, Osaka City General Hospital, Osaka, Japan; Department of Post-infectious Disease Therapeutics, Graduate School of Medicine, Osaka University, Osaka, Japan; Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Osaka, Japan.
| | - Hiroo Matsuo
- Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Michinori Shirano
- Department of Infectious Diseases, Osaka City General Hospital, Osaka, Japan
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Trickey A, Ambia J, Glaubius R, van Schalkwyk C, Imai‐Eaton JW, Korenromp EL, Johnson LF. Excess mortality attributable to AIDS among people living with HIV in high-income countries: a systematic review and meta-analysis. J Int AIDS Soc 2024; 27:e26384. [PMID: 39496514 PMCID: PMC11534483 DOI: 10.1002/jia2.26384] [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: 05/13/2024] [Accepted: 10/08/2024] [Indexed: 11/06/2024] Open
Abstract
INTRODUCTION Identifying strategies to further reduce AIDS-related mortality requires accurate estimates of the extent to which mortality among people living with HIV (PLHIV) is due to AIDS-related or non-AIDS-related causes. Existing approaches to estimating AIDS-related mortality have quantified AIDS-related mortality as total mortality among PLHIV in excess of age- and sex-matched mortality in populations without HIV. However, recent evidence suggests that, with high antiretroviral therapy (ART) coverage, a growing proportion of excess mortality among PLHIV is non-AIDS-related. METHODS We searched Embase on 22/09/2023 for English language studies that contained data on AIDS-related mortality rates among adult PLHIV and age-matched comparator all-cause mortality rates among people without HIV. We extracted data on the number and rates of all-cause and AIDS-related deaths, demographics, ART use and AIDS-related mortality definitions. We calculated the proportion of excess mortality among PLHIV that is AIDS-related. The proportion of excess mortality due to AIDS was pooled using random-effects meta-analysis. RESULTS Of 4485 studies identified by the initial search, eight were eligible, all from high-income settings: five from Europe, one from Canada, one from Japan and one from South Korea. No studies reported on mortality among only untreated PLHIV. One study included only PLHIV on ART. In all studies, most PLHIV were on ART by the end of follow-up. Overall, 1,331,742 person-years and 17,471 deaths were included from PLHIV, a mortality rate of 13.1 per 1000 person-years. Of these deaths, 7721 (44%) were AIDS-related, an overall AIDS-related mortality rate of 5.8 per 1000 person-years. The mean overall mortality rate among the general population was 2.8 (95% CI: 1.8-4.0) per 1000 person-years. The meta-analysed percentage of excess mortality that was AIDS-related was 53% (95% CI: 45-61%); 52% (43-60%) in Western and Central Europe and North America, and 71% (69-74%) in the Asia-Pacific region. DISCUSSION Although we searched all regions, we only found eligible studies from high-income countries, mostly European, so, the generalizability of these results to other regions and epidemic settings is unknown. CONCLUSIONS Around half of the excess mortality among PLHIV in high-income regions was non-AIDS-related. An emphasis on preventing and treating comorbidities linked to non-AIDS mortality among PLHIV is required.
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Affiliation(s)
- Adam Trickey
- Population Health SciencesUniversity of BristolBristolUK
| | - Julie Ambia
- Population Health SciencesUniversity of BristolBristolUK
| | - Robert Glaubius
- Center for Modeling, Planning and Policy AnalysisAvenir HealthGlastonburyConnecticutUSA
| | - Cari van Schalkwyk
- The South African Centre for Epidemiological Modelling and AnalysisUniversity of StellenboschStellenboschSouth Africa
| | - Jeffrey W. Imai‐Eaton
- Center for Communicable Disease DynamicsDepartment of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
- MRC Centre for Global Infectious Disease Analysis, School of Public HealthImperial College LondonLondonUK
| | - Eline L. Korenromp
- Data for Impact DepartmentUnited Nations Programme on HIV/AIDSGenevaSwitzerland
| | - Leigh F. Johnson
- Centre for Infectious Disease Epidemiology and Research, School of Public HealthUniversity of Cape TownCape TownSouth Africa
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Román López CG, Triana González S, Cano Díaz AL, Lopez DDF, Mata Marín JA, Gaytán Martínez JE. Effectiveness of Direct Antiviral Agents in People with HCV-Monoinfection Compared to HCV/HIV Coinfection in a Real Life Setting. Viruses 2024; 16:1724. [PMID: 39599839 PMCID: PMC11599026 DOI: 10.3390/v16111724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2024] [Revised: 10/14/2024] [Accepted: 10/26/2024] [Indexed: 11/29/2024] Open
Abstract
Direct-acting antivirals (DAA) are effective in patients with hepatitis C virus (HCV) infection, but there is little information about real-world effectiveness in people living with human immunodeficiency virus (PLH). The aim of this study was to determinate the effectiveness of DAA to achieve sustained virologic response at week 12 post-treatment (SVR12) in PLH with HCV coinfection and in people with HCV-monoinfection. We conducted a prospective cohort. The full analysis set (FAS) included all subjects enrolled in the study; the modified analysis set (MAS) excluded cases with missing data to evaluate SVR12. A total of 278 people were included, 130 (46.7%) with HCV/HIV-coinfection and 148 (53.2%) with HCV-monoinfection. In the HCV/HIV-coinfection group, 82 (63%) received GLE/PIB for 8 weeks, 45 (34.6%) received SOF/VEL for 12 weeks, and 3 (2.3%) were treated with SOF/VEL + RBV for 12 weeks. In the HCV-monoinfection group, 62 (41.8%) received GLE/PIB for 8 weeks, 28 (18.9%) received SOF/VEL for 12 weeks, and 58 (39.1%) participants were treated with SOF/VEL + RBV for 12 weeks. In the FAS analysis, SVR12 was 81.6% in the HCV/HIV-coinfection group and 86.4% in the HCV-monoinfection group (p = 0.128). In the MAS analysis, both groups achieved 100% of SVR12. In this cohort, the effectiveness of DAA to achieve SVR12 was similar between HCV/HIV-coinfection and HCV-monoinfection cases, regardless of advanced liver disease with no differences between treatment regimens.
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Affiliation(s)
- Cristina Guadalupe Román López
- Internal Medicine Department, Hospital Regional No. 1 “Ignacio García Tellez”, Instituto Mexicano del Seguro Social, Mérida 97150, Yucatán, Mexico;
| | - Salma Triana González
- Infectious Diseases Department, Hospital de Infectologia “La Raza” National Medical Center, Instituto Mexicano del Seguro Social, Mexico City 02990, Mexico; (S.T.G.); (A.L.C.D.); (D.D.F.L.); (J.E.G.M.)
| | - Ana Luz Cano Díaz
- Infectious Diseases Department, Hospital de Infectologia “La Raza” National Medical Center, Instituto Mexicano del Seguro Social, Mexico City 02990, Mexico; (S.T.G.); (A.L.C.D.); (D.D.F.L.); (J.E.G.M.)
| | - Dulce Daniela Flores Lopez
- Infectious Diseases Department, Hospital de Infectologia “La Raza” National Medical Center, Instituto Mexicano del Seguro Social, Mexico City 02990, Mexico; (S.T.G.); (A.L.C.D.); (D.D.F.L.); (J.E.G.M.)
| | - José Antonio Mata Marín
- Infectious Diseases Department, Hospital de Infectologia “La Raza” National Medical Center, Instituto Mexicano del Seguro Social, Mexico City 02990, Mexico; (S.T.G.); (A.L.C.D.); (D.D.F.L.); (J.E.G.M.)
| | - Jesús Enrique Gaytán Martínez
- Infectious Diseases Department, Hospital de Infectologia “La Raza” National Medical Center, Instituto Mexicano del Seguro Social, Mexico City 02990, Mexico; (S.T.G.); (A.L.C.D.); (D.D.F.L.); (J.E.G.M.)
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10
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Dinh DA, Tan Y, Saeed S. Disengagement from Care Among People Co-Infected with HIV and HCV: A Scoping Review. AIDS Behav 2024; 28:3381-3403. [PMID: 38992228 DOI: 10.1007/s10461-024-04436-6] [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] [Accepted: 06/27/2024] [Indexed: 07/13/2024]
Abstract
Disengagement from care among people with HIV (PWH) and hepatitis C (HCV) increases the risks of adverse health outcomes and poses significant barriers to achieving global HIV and HCV elimination goals. In accordance with the Joanna Briggs Institute framework, a scoping review was conducted to synthesize and highlight existing gaps in the literature on (dis)engagement in care among PWH and HCV. We searched for original studies on (dis)engagement in care among PWH and HCV in high-income countries using eight electronic databases from inception to May 2023. Our search yielded 4462 non-duplicated records, which were scoped to 27 studies. Definitions of (dis)engagement in care were diverse, with considerable heterogeneity in how retention was operationalized and temporally measured. Studies identified predictors of (dis)engagement to be related to drug and substance use (n = 5 articles), clinical factors (n = 5), social and welfare (n = 4), and demographic characteristics (n = 2). When engagement in care was treated as an exposure, it was associated with HCV treatment initiation (n = 3), achieving sustained virological response (n = 2), and maintaining HIV viral suppression (n = 1). Interventions to improve care engagement among PWH and HCV were limited to five studies using cash incentives (n = 1) and individual case management (n = 4). (Dis)engagement in care is a dynamic process influenced by shifting priorities that may 'tip the balance' towards or away from regularly interacting with healthcare professionals. However, inconsistent definitions render cross-study comparisons and meta-analyses virtually impossible. Further research needs to establish a standardized definition to identify patients at high risk of disengagement and develop interventions that leverage the nested HIV/HCV care cascades to retain and recover patients lost from care.
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Affiliation(s)
- Duy A Dinh
- Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Yvonne Tan
- Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Sahar Saeed
- Department of Public Health Sciences, Queen's University, 203 Carruthers Hall 62 Fifth Field Company Lane, Kingston, ON, K7L 3N6, Canada.
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11
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Chiu I, Cano D, Leathers M, Turner CM, Trujillo D, Sicro S, Arayasirikul S, Taylor KD, Wilson EC, McFarland W. HIV and hepatitis C virus infection and co-infection among trans women in San Francisco, 2020. PLoS One 2024; 19:e0307990. [PMID: 39312538 PMCID: PMC11419358 DOI: 10.1371/journal.pone.0307990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 07/11/2024] [Indexed: 09/25/2024] Open
Abstract
BACKGROUND Transgender women (hereafter "trans women") face social marginalization, stigma, and discrimination and experience a high burden of HIV. More recently, trans women have been identified as having a high risk for hepatitis C (HCV) infection. The interaction between these two diseases and the risks for HIV/HCV co-infection among trans women are understudied. OBJECTIVE To characterize epidemiological, behavioral, and socio-structural interactions between HIV and HCV infections among trans women. METHODS This cross-sectional study examined data from a community-based survey of trans women in San Francisco recruited through respondent-driven sampling (RDS) in 2019/2020. Face-to-face interviews collected data on demographics, medical history, drug injection practices, sexual behavior, and socio-structural factors (e.g., poverty, housing insecurity, incarceration, social support). HIV and HCV antibodies were detected using oral fluid rapid tests and prior diagnosis and treatment were collected by self-report. Blood specimens were collected to confirm antibodies using ELISA. Multinomial logistic regression analysis characterized factors associated with HIV infection alone, HCV infection alone, and HIV/HCV co-infection compared to neither infection. RESULTS Among 201 trans women recruited, HIV prevalence was 42.3%; HCV infection by history or current seroprevalence was 28.9%; evidence for both HIV and HCV infection was present for 18.9%. Two-thirds of trans women (67.2%) had been incarcerated; 30.8% had ever injected drugs. History of injection drug use and receiving emotional support from family were factors found in common for HIV infection, HCV infection, and HIV/HCV co-infection compared to no infection. Having a sexual partner who injects drugs was associated with HIV infection alone. Not lacking care due to cost and older age were associated with co-infection. Older age was also associated with HCV infection. Of trans women with HIV infection, 91.8% had accessed HIV care, whereas only 62% with HCV had accessed some form of care. CONCLUSIONS Our study found high levels of HIV, HCV, and HIV/HCV co-infection among trans women in San Francisco. We found common associations between HIV and HCV through injection practices and emotional support, but having a sexual partner who injects drugs was not associated with HCV infection alone or co-infection. We note a substantial gap in the treatment of HCV for trans women, including those in HIV care, that needs to be urgently addressed.
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Affiliation(s)
- Izzy Chiu
- Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, United States of America
- Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States of America
| | - Damiana Cano
- Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States of America
- University of California Berkeley, Berkeley, CA, United States of America
| | - Matisse Leathers
- Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States of America
- University of California Berkeley, Berkeley, CA, United States of America
| | - Caitlin M. Turner
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States of America
| | - Dillon Trujillo
- Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Sofia Sicro
- Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States of America
| | - Sean Arayasirikul
- Department of Health, Society, & Behavior, University of California, Irvine, Irvine, CA, United States of America
| | - Kelly D. Taylor
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States of America
| | - Erin C. Wilson
- Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States of America
| | - Willi McFarland
- Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States of America
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States of America
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12
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Jamshaid M, Heidari A, Hassan A, Mital D, Pearce O, Panourgia M, Ahmed MH. Bone Loss and Fractures in Post-Menopausal Women Living with HIV: A Narrative Review. Pathogens 2024; 13:811. [PMID: 39339002 PMCID: PMC11435029 DOI: 10.3390/pathogens13090811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2024] [Revised: 09/07/2024] [Accepted: 09/11/2024] [Indexed: 09/30/2024] Open
Abstract
INTRODUCTION Post-menopausal women living with Human Immunodeficiency Virus (WLHIV) face an increased risk of bone fractures due to the relationship between HIV-related factors and menopause. This narrative review aims to summarise the current knowledge about fracture risk among post-menopausal WLHIV in particular looking at hormonal changes, combined antiretroviral therapy (cART), lifestyle factors, and psychosocial implications. We also profiled a summary of the significant, recent studies of post-menopausal WLHIV residing in low-income countries (LIC). METHODS A thorough search of the literature was performed across PubMed, Medline, Scopus, and Google Scholar, focussing on studies published between 2000 and 2024. Inclusion criteria entailed original research, reviews, and meta-analyses addressing bone mineral density (BMD), fracture incidence, and related risk factors in post-menopausal WLHIV. RESULTS The review identified 223 relevant studies. Post-menopausal WLHIV exhibit significantly lower BMD and higher fracture rates compared to both HIV-negative post-menopausal women and pre-menopausal WLHIV. cART, particularly tenofovir disoproxil fumarate (TDF), contributes to reduced BMD. Menopausal status exacerbates this risk through decreased oestrogen levels, leading to increased bone resorption. Moreover, lifestyle choices such as smoking, alcohol consumption, and low physical activity are more prevalent in PWHIV, which further elevates fracture risk. Different psychosocial factors may make WLWHIV more vulnerable at this stage of their life, such as depression, isolation, stigma, and housing and nutritional issues. Women living in LICs face a variety of challenges in accessing HIV care. There are gaps in research related to the prevalence of osteoporosis and bone loss in post-menopausal WLHIV in LICs. CONCLUSION Post-menopausal women living with HIV face a significantly higher risk of bone loss and fractures due to the combined effects of HIV and menopause. Antiretroviral therapy (particularly TDF), lifestyle factors, and psychosocial challenges exacerbate this risk. There is a need for careful selection of cART, hormone replacement therapy (HRT), and emerging treatments such as Abaloparatide. A holistic approach including lifestyle changes and psychosocial support is crucial to reduce fracture risk in WLHIV, especially in low-income countries.
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Affiliation(s)
- Maryam Jamshaid
- Department of Trauma and Orthopaedics, Liverpool University Hospital NHS Trust, Liverpool L69 3BX, UK
- School of Medicine, University of Liverpool, Liverpool L69 3BX, UK
| | - Amirmohammad Heidari
- Department of Trauma and Orthopaedics, Liverpool University Hospital NHS Trust, Liverpool L69 3BX, UK
- School of Medicine, University of Liverpool, Liverpool L69 3BX, UK
| | - Ahmed Hassan
- Faculty of Medicine, Alexandria University, Alexandria 21500, Egypt
| | - Dushyant Mital
- Department of HIV and Blood Borne Virus, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes MK6 5LD, UK
| | - Oliver Pearce
- Department of Trauma and Orthopaedics, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes MK6 5LD, UK
| | - Maria Panourgia
- Department of Geriatric Medicine, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes MK6 5LD, UK
- Faculty of Medicine and Health Sciences, University of Buckingham, Buckingham MK18 1EG, UK
| | - Mohamed H Ahmed
- Department of Geriatric Medicine, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes MK6 5LD, UK
- Faculty of Medicine and Health Sciences, University of Buckingham, Buckingham MK18 1EG, UK
- Department of Medicine and HIV Metabolic Clinic, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes MK6 5LD, UK
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13
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Sohal A, Singh C, Bhalla A, Kalsi H, Roytman M. Renal Manifestations of Chronic Hepatitis C: A Review. J Clin Med 2024; 13:5536. [PMID: 39337023 PMCID: PMC11433393 DOI: 10.3390/jcm13185536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2024] [Revised: 09/13/2024] [Accepted: 09/16/2024] [Indexed: 09/30/2024] Open
Abstract
Hepatitis C virus (HCV) has emerged as a major global health concern and, if left untreated, can lead to significant liver damage, including cirrhosis, decompensated liver disease, and hepatocellular carcinoma (HCC). Approximately 40% of patients with HCV infection experience extrahepatic manifestations, including renal involvement. HCV-related renal disease is of significant importance among patients with chronic kidney disease (CKD), leading to higher morbidity and mortality. The renal damage due to HCV infection primarily results from cryoglobulinemia and glomerulonephritis, with conditions such as membranoproliferative glomerulonephritis (MPGN) and membranous nephropathy (MN) being most prevalent. Despite advancements in treatment, including the use of directly acting antiviral agents (DAAs), renal complications remain a significant burden in untreated patients. HCV-positive patients on hemodialysis (HD) or those who have undergone kidney transplantation face increased mortality rates compared to their HCV-negative counterparts. Managing HCV infection before kidney transplantation is crucial to mitigate the risk of HCV-related renal complications. Conversely, kidney transplantation from HCV-infected donors is well established, as post-transplant treatment for HCV is safe and effective, potentially reducing mortality and morbidity for patients on transplant waiting lists. This review aims to provide a comprehensive analysis of the renal manifestations of HCV, emphasizing the importance of early diagnosis and treatment to improve patient outcomes.
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Affiliation(s)
- Aalam Sohal
- Division of Gastroenterology and Hepatology, Creighton University School of Medicine, Phoenix, AZ 2500, USA
| | - Carol Singh
- Department of Internal Medicine, Dayanand Medical College and Hospital, Ludhiana 141001, Punjab, India
| | - Akshita Bhalla
- Department of Internal Medicine, Punjab Institute of Medical Sciences, Jalandhar 144006, Punjab, India
| | - Harsimran Kalsi
- Department of Internal Medicine, University of Central Florida College of Medicine, Orlando, FL 32827, USA
| | - Marina Roytman
- Division of Gastroenterology and Hepatology, University of California San Francisco, Fresno, CA 93701, USA
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Zuniga JM, Prachniak C, Policek N, Magula N, Gandhi A, Anderson J, Diallo DD, Lima VD, Ravishankar S, Acharya S, Achrekar A, Adeleke M, Aïna É, Baptiste S, Barrow G, Begovac J, Bukusi E, Castel A, Castellanos E, Cestou J, Chirambo G, Crowley J, Dedes N, Ditiu L, Doherty M, Duncombe C, Durán A, Futterman D, Hader S, Kounkeu C, Lawless F, Lazarus JV, Lex S, Lobos C, Mayer K, Mejia M, Moheno HR, d'Arminio Monforte A, Morán-Arribas M, Nagel D, Ndugwa R, Ngunu C, Poonkasetwattana M, Prins M, Quesada A, Rudnieva O, Ruth S, Saavedra J, Toma L, Wanjiku Njenga L, Williams B. IAPAC-Lancet HIV Commission on the future of urban HIV responses. Lancet HIV 2024; 11:e607-e648. [PMID: 39043198 DOI: 10.1016/s2352-3018(24)00124-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 04/26/2024] [Accepted: 05/02/2024] [Indexed: 07/25/2024]
Affiliation(s)
- José M Zuniga
- International Association of Providers of AIDS Care, Washington, DC, USA; Fast-Track Cities Institute, Washington, DC, USA.
| | | | | | | | - Anisha Gandhi
- New York City Department of Health and Mental Hygiene, New York, NY, USA
| | | | | | | | | | | | | | | | | | - Solange Baptiste
- International Treatment Preparedness Coalition, Johannesburg, South Africa
| | | | | | - Elizabeth Bukusi
- Kenya Medical Research Institute, Nairobi, Kenya; University of Nairobi, Nairobi, Kenya
| | | | | | - Jorge Cestou
- Chicago Department of Public Health, Chicago, IL, USA
| | | | | | | | | | - Meg Doherty
- World Health Organization, Geneva, Switzerland
| | - Chris Duncombe
- International Association of Providers of AIDS Care, Washington, DC, USA
| | - Adriana Durán
- Ministry of Health, City of Buenos Aires, Buenos Aires, Argentina
| | | | | | - Chyrol Kounkeu
- Cameroonian Association for the Development and Empowerment of Vulnerable People, Yaoundé, Cameroon
| | - Fran Lawless
- Mayor's Office of Health Policy, New Orleans, LA, USA
| | - Jeffrey V Lazarus
- University of Barcelona, Barcelona, Spain; CUNY Graduate School of Public Health and Policy, New York, NY, USA
| | | | | | - Kenneth Mayer
- Fenway Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | | | | | | | | | | | | | - Carol Ngunu
- Nairobi City County Department of Health, Nairobi, Kenya
| | | | - Maria Prins
- Academic Medical Center, Amsterdam, Netherlands
| | - Amara Quesada
- Action for Health Initiatives, Quezon City, Philippines
| | | | - Simon Ruth
- Thorne Harbour Health, Melbourne, VIC, Australia
| | | | - Lance Toma
- San Francisco Community Health Center, San Francisco, CA, USA
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15
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Lee S, Lee JE, Lee SO, Lee SH. Treatment Outcomes of HCV Infection in People Living with HIV: A Case Series from a Single Center in Korea. Infect Chemother 2024; 56:386-394. [PMID: 39370124 PMCID: PMC11458507 DOI: 10.3947/ic.2024.0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Accepted: 08/26/2024] [Indexed: 10/08/2024] Open
Abstract
BACKGROUND Limited information is available on the clinical course and treatment outcomes of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) coinfection in Korea. MATERIALS AND METHODS A retrospective case series was conducted of patients with HIV-HCV coinfection who received interferon (IFN)-based or direct-acting antiviral (DAA) treatment for HCV at a tertiary care hospital between 2000 and 2023. Early virological response (EVR) was defined as a 2-log reduction in HCV RNA levels or undetectable HCV RNA levels at treatment week 12. A sustained virologic response (SVR) was defined as undetectable HCV RNA at 12 weeks after treatment completion. RESULTS Of the 33 patients with HIV-HCV coinfection, 19 received anti-HCV treatment, of whom 12 received IFN-based treatment and 10 received DAA treatment. The median age at the time of anti-HCV treatment was 49 years (interquartile range, 42-57 years) and 15 patients (79%) were male. Of the 12 patients who received IFN-based anti-HCV treatment, 10 showed EVR and 8 achieved SVR. However, 2 patients who achieved SVR experienced recurrence of HCV infection during follow-up; therefore, the overall success rate of IFN-based treatment was 50% (6/12). All 10 patients (including 3 in whom IFN-based treatment failed) who received DAA treatment (5 with previous anti-HCV treatment and 5 treatment-naïve), achieved SVR and did not experience recurrence of HCV infection during follow-up; therefore, the overall success rate of DAA treatment was 100%. CONCLUSION In Korean patients with HIV-HCV coinfection, treatment outcomes were better with DAA treatment than with IFN-based treatment.
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Affiliation(s)
- Shinwon Lee
- Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jeong Eun Lee
- Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Soon Ok Lee
- Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Sun Hee Lee
- Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan, Korea.
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16
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Mostafavi E, Ebrahimi B, Doosti-Irani A, Mirzazadeh A. Prevalence of hepatitis B, hepatitis C, and tuberculosis among people living with HIV in Iran: a systematic review and meta-analysis. BMC Infect Dis 2024; 24:777. [PMID: 39097724 PMCID: PMC11297631 DOI: 10.1186/s12879-024-09676-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 07/25/2024] [Indexed: 08/05/2024] Open
Abstract
BACKGROUND Up to now several studies estimate the prevalence of HBV, HCV, and TB among people living with HIV (PLWH) in Iran; however, their results are inconsistent. This study aimed to estimate the overall prevalence of HBV, HVC, and TB among Iranian PLWH. METHODS In this systematic review and meta-analysis six databases including Medline, Web of Science, Scopus, MagIran, Scientific Information Database (SID), and Barakat Knowledge network system were searched up to October 2023 with no language restriction. All studies estimated the prevalence of HBV, HCV, and TB among PLWH in Iran were included. The random-effects model was used to report the study estimates. Results were reported at a 95% confidence interval (CI). RESULTS Out of 1050 retrieved references, 58 articles met the eligibility criteria. Overall among PLWH, HBV prevalence was 13.0% (95% CI: 11.0, 15.0), HCV prevalence was 54% (95% CI: 45.0, 64.0), and TB prevalence was 19% (95% CI: 13.0, 24.0). The results from multivariate meta-regression analysis showed no statistically significant association between HBV and TB prevalence with the year of study, quality of studies, age, gender, and persons who inject drugs (PWID). HCV prevalence was significantly associated with PWID. CONCLUSION We found HBV, HCV, and TB infections are common among PLWH in Iran and required to be screened and treated with effective and timely services.
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Affiliation(s)
- Ehsan Mostafavi
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Bahram Ebrahimi
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Science, Hamadan, Iran
| | - Amin Doosti-Irani
- Department of Epidemiology, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Ali Mirzazadeh
- HIV/STI Surveillance Research Center, and WHO Collaborating for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Epidemiology and Biostatistics, Institute for Global Health Sciences, University of California, San Francisco, CA, USA
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17
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Elliott S, Flynn E, Mathew S, Hajarizadeh B, Martinello M, Wand H, Ward J. Prevalence of hepatitis C virus exposure and infection among Indigenous and tribal populations: a global systematic review and meta-analysis. Public Health 2024; 233:65-73. [PMID: 38850603 DOI: 10.1016/j.puhe.2024.04.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 04/23/2024] [Accepted: 04/25/2024] [Indexed: 06/10/2024]
Abstract
OBJECTIVES The objective of this study was to estimate prevalence of hepatitis C virus (HCV) exposure and infection among Indigenous and tribal populations globally. STUDY DESIGN Systematic review and meta-analysis. METHODS We systematically searched bibliographic databases and grey literature (1/01/2000-16/06/2022). Prevalence estimates were synthesised overall, by World Health Organization region and HCV-risk group. For studies with comparator populations, prevalence ratios were estimated and pooled. RESULTS Ninety-two studies were included. Globally, among general Indigenous and tribal populations, the median prevalence of HCV antibody (HCV Ab) was 1.3% (interquartile range [IQR]: 0.3-3.8%, I2 = 98.5%) and HCV RNA was 0.4% (IQR: 0-1.3%, I2 = 96.1%). The Western Pacific Region had the highest prevalence (HCV Ab: median: 3.0% [IQR: 0.4-11.9%], HCV RNA: median 5.6% [IQR: 2.0-8.8%]). Prevalence was highest in people who injected drugs (HCV Ab: median: 59.5%, IQR: 51.5-67.6%, I2 = 96.6%; and HCV RNA: median: 29.4%, IQR: 21.8-35.2%, I2 = 97.2%). There was no association between HCV Ab prevalence and Indigenous/tribal status for general populations (prevalence ratio = 0.91; 95% CI: 0.56, 1.49) or key risk groups. CONCLUSIONS Indigenous and tribal peoples from the Western Pacific Region and recognised at-risk sub-populations had higher HCV prevalence. HCV prevalence showed no association with Indigenous/tribal status. However, this review was limited by heterogeneity and poor quality of constituent studies, varying definitions of Indigenous/tribal status, regional data gaps, and limited studies on chronic infection (HCV RNA). Comprehensive quality evidence on HCV epidemiology in Indigenous and tribal peoples is needed to tailor preventive and treatment interventions so these populations are not left behind in elimination efforts.
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Affiliation(s)
- S Elliott
- Poche Centre for Indigenous Health, University of Queensland, Brisbane, Queensland, Australia.
| | - E Flynn
- Poche Centre for Indigenous Health, University of Queensland, Brisbane, Queensland, Australia; South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - S Mathew
- Poche Centre for Indigenous Health, University of Queensland, Brisbane, Queensland, Australia
| | - B Hajarizadeh
- Kirby Institute, UNSW, Sydney, New South Wales, Australia
| | - M Martinello
- Kirby Institute, UNSW, Sydney, New South Wales, Australia
| | - H Wand
- Kirby Institute, UNSW, Sydney, New South Wales, Australia
| | - J Ward
- Poche Centre for Indigenous Health, University of Queensland, Brisbane, Queensland, Australia
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Tirmizi R, Munir R, Zaidi N. Trends in hepatitis C virus seroprevalence and associated risk factors among msm in Pakistan: insights from a community-based study. Sci Rep 2024; 14:16551. [PMID: 39019899 PMCID: PMC11255259 DOI: 10.1038/s41598-024-63351-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 05/28/2024] [Indexed: 07/19/2024] Open
Abstract
Pakistan bears a substantial burden of hepatitis C virus (HCV) infection, with the second-highest prevalence globally. This community-based cross-sectional study, conducted from January to December 2022 in Punjab, Pakistan, investigates the seroprevalence of HCV among the men who have sex with men (MSM) population. The study identifies demographic and behavioral risk factors associated with HCV infection within this population group. Among the 501 participants, the study found an HCV seroprevalence of 14.86%. The association between demographic characteristics and seroprevalence is assessed by calculating the percentage of positive cases, revealing notable associations with age, education level, and self-identified sexual orientation. Furthermore, the study identified several behavioral risk factors positively associated with HCV seroprevalence, including sharing personal items such as razors and toothbrushes, histories of surgery, blood transfusion, dental procedures, intravenous drug use, and therapeutic injection histories. These risk factors were identified through structured interviews, and the prevalence of HCV seropositivity among the exposed groups was calculated accordingly. Interestingly, a lower HCV positivity rate was observed among self-reported HIV-positive individuals, contradicting previous research. The findings underscore the need for comprehensive, targeted prevention strategies such as risk factor awareness campaigns and educational programs tailored for the MSM population in Pakistan. Further research is warranted to validate these findings and better understand the complex interplay of factors contributing to HCV seroprevalence in this high-risk population.
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Affiliation(s)
- Raza Tirmizi
- Dostana Male Health Society, Lahore, Pakistan
- Action Research Collective, Lahore, Pakistan
| | - Rimsha Munir
- Action Research Collective, Lahore, Pakistan
- Hormone Lab Lahore, Lahore, Pakistan
| | - Nousheen Zaidi
- Cancer Biology Lab, Institute of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan.
- Cancer Research Centre, University of the Punjab, Lahore, Pakistan.
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Ryan P, Valencia J, Cuevas G, Amigot-Sanchez R, Martínez I, Lazarus JV, Pérez-García F, Resino S. Decrease in active hepatitis C infection among people who use drugs in Madrid, Spain, 2017 to 2023: a retrospective study. Euro Surveill 2024; 29:2300712. [PMID: 39027941 PMCID: PMC11258947 DOI: 10.2807/1560-7917.es.2024.29.29.2300712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 04/24/2024] [Indexed: 07/20/2024] Open
Abstract
BackgroundPeople who use drugs (PWUD) are a key target population to reduce the burden of hepatitis C virus (HCV) infection.AimTo assess risk factors and temporal trends of active HCV infection in PWUD in Madrid, Spain.MethodsWe conducted a retrospective study between 2017 and 2023, including 2,264 PWUD visiting a mobile screening unit. Data about epidemiology, substance use and sexual risk behaviour were obtained through a 92-item questionnaire. HCV was detected by antibody test, followed by RNA test. The primary outcome variable was active HCV infection prevalence, calculated considering all individuals who underwent RNA testing and analysed by logistic regression adjusted by the main risk factors.ResultsOf all participants, 685 tested positive for anti-HCV antibodies, and 605 underwent RNA testing; 314 had active HCV infection, and 218 initiated treatment. People who inject drugs (PWID) were identified as the main risk group. The active HCV infection rate showed a significant downward trend between 2017 and 2023 in the entire study population (23.4% to 6.0%), among PWID (41.0% to 15.0%) and PWUD without injecting drug use (7.0% to 1.3%) (p < 0.001 for all). These downward trends were confirmed by adjusted logistic regression for the entire study population (adjusted odds ratio (aOR): 0.78), PWID (aOR: 0.78), and PWUD non-IDU (aOR: 0.78).ConclusionsOur study demonstrates a significant reduction in active HCV infection prevalence among PWUD, particularly in PWID, which suggests that efforts in the prevention and treatment of HCV in Madrid, Spain, have had an impact on the control of HCV infection.
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Affiliation(s)
- Pablo Ryan
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Hospital Universitario Infanta Leonor, Madrid, Spain
- Universidad Complutense de Madrid (UCM), Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Jorge Valencia
- Unidad de Reducción de Daños 'SMASD', Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Hospital Universitario Infanta Leonor, Madrid, Spain
| | | | - Rafael Amigot-Sanchez
- Unidad de Infección e Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Isidoro Martínez
- Unidad de Infección e Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Jeffrey V Lazarus
- CUNY Graduate School of Public Health and Health Policy (CUNY SPH), New York, United States
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Felipe Pérez-García
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Servicio de Microbiología Clínica, Hospital Universitario Príncipe de Asturias, Madrid, Spain
- Universidad de Alcalá, Facultad de Medicina, Departamento de Biomedicina y Biotecnología, Madrid, Spain
| | - Salvador Resino
- Unidad de Infección e Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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20
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Shabil M, Yadav A, Shamim MA, Ahmed M, Satapathy P, Zaidan AA, Khatib MN, Gaidhane S, Zahiruddin QS, Rabaan AA, Al Kaabi NA, Almosa FAM, AlSihati J, Sah R. Prevalence of hepatitis B and C infections among HIV-positive men who have sex with men: A systematic review and meta-analysis. Health Sci Rep 2024; 7:e2206. [PMID: 38933421 PMCID: PMC11199987 DOI: 10.1002/hsr2.2206] [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: 12/02/2023] [Revised: 05/10/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024] Open
Abstract
Background Human immunodeficiency virus (HIV) infection is highly prevalent and often coexists with other infectious diseases, especially Hepatitis B virus (HBV) and Hepatitis C virus (HCV). Men who have sex with men (MSM) represent a vulnerable population in terms of HIV infection. We aimed to determine the prevalence of HCV, HBV among HIV-infected MSM. Methods This systematic review and meta-analysis searched PubMed, Cochrane, Scopus, Web of Science, and ProQuest up-to 2023/04/22. All studies reporting the prevalence of HBV or HCV infection in MSM PLHIV were included. Meta-analysis used random effect model for synthesis and I 2 along with prediction interval for heterogeneity. Subgroup analysis based on continent and meta-regression for study size, average age and year of publication were used to explore heterogeneity. Modified Newcastle-Ottawa Scale was used to evaluate the quality of studies according to the protocol (PROSPERO: CRD42023428764). Results Fifty-six of 5948 studies are included. In 53 studies with 3,07,589 participants, a pooled prevalence of 7% (95% confidence interval [CI]: 5-10) was found for HCV among MSM PLHIV, while a 9% (95% CI: 4-18) prevalence was found for HBV infection from five studies which included 5641 MSM PLHIV. Asia reported the lowest pooled prevalence at 5.84% (95% CI: 2.98-11.13) for HCV while Europe reported the highest pooled prevalence at 7.76% (95% CI: 4.35-13.45). Baujat plot and influence diagnostic identified contributors to influence and between-study heterogeneity. Sensitivity analyses omitting these studies result in considerably more precise estimates. Another sensitivity analysis as leave-one-out meta-analysis did not change any pooled estimate significantly. Conclusion There is a significant burden of HCV and HBV among MSM PLHIV worldwide, with varying prevalence rates. Future studies should focus on these multimorbidity clusters and investigate factors influencing disease burden, long-term outcomes, optimal testing strategies, and tailored interventions.
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Affiliation(s)
- Muhammed Shabil
- Evidence of Policy and LearningGlobal Center for Evidence SynthesisChandigarhIndia
| | - Aarti Yadav
- Evidence of Policy and LearningGlobal Center for Evidence SynthesisChandigarhIndia
| | - Muhammed A. Shamim
- Department of PharmacologyAll India Institute of Medical SciencesJodhpurIndia
| | - Mohammed Ahmed
- School of Medical SciencesUniversity of HyderabadHyderabadIndia
| | - Prakasini Satapathy
- Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical SciencesSaveetha UniversityChennaiIndia
- Medical Laboratories Techniques DepartmentAL‐Mustaqbal UniversityHillahBabilIraq
| | - Ali A. Zaidan
- Gastroenterology DepartmentKing Fahad Armed Forces HospitalJeddahSaudi Arabia
| | - Mahalaqua N. Khatib
- Division of Evidence Synthesis, Global Consortium of Public Health and ResearchDatta Meghe Institute of Higher EducationWardhaIndia
| | - Shilpa Gaidhane
- One Health Centre (COHERD), Jawaharlal Nehru Medical CollegeDatta Meghe Institute of Higher EducationWardhaIndia
| | - Quazi S. Zahiruddin
- Global Health Academy, Division of Evidence Synthesis, School of Epidemiology and Public Health and Research, Jawaharlal Nehru Medical CollegeInstitute of Higher education and ResearchWardhaIndia
| | - Ali A. Rabaan
- Molecular Diagnostic LaboratoryJohns Hopkins Aramco HealthcareDhahranSaudi Arabia
- College of MedicineAlfaisal UniversityRiyadhSaudi Arabia
- Department of Public Health and NutritionThe University of HaripurHaripurPakistan
| | - Nawal A. Al Kaabi
- College of Medicine and Health ScienceKhalifa UniversityAbu DhabiUnited Arab Emirates
- Sheikh Khalifa Medical CityAbu Dhabi Health Services Company (SEHA)Abu DhabiUnited Arab Emirates
| | - Fadel A. M. Almosa
- Gastroenterology Unit, Department of Internal Medicine, Qatif Central HospitalMinistry of HealthQatifSaudi Arabia
| | - Jehad AlSihati
- Internal Medicine Department, Gastroenterology SectionKing Fahad Specialist HospitalDammamSaudi Arabia
| | - Ranjit Sah
- Department of MicrobiologyTribhuvan University Teaching HospitalKathmanduNepal
- Department of Clinical Microbiology, DY Patil Medical College, Hospital and Research CentreDY Patil VidyapeethPuneMaharashtraIndia
- Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and HospitalDr. D.Y. Patil VidyapeethPuneMaharashtraIndia
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21
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Fratzl M, Bigotte P, Gorbenkov R, Goubet G, Halfon P, Kauffmann P, Kirk D, Masse V, Payet-Burin X, Ramel O, Delshadi S. Magnetically localized and wash-free fluorescent immuno-assay: From a research platform (MLFIA) to a multiplexed POC system (MagIA). SLAS Technol 2024; 29:100119. [PMID: 38302059 DOI: 10.1016/j.slast.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/21/2023] [Accepted: 01/23/2024] [Indexed: 02/03/2024]
Abstract
Sexually transmitted infections (STI) remain one of the world's public health priorities: Nearly 400 million people are infected not only in emerging, but also in western countries. HIV, HBV and HCV share common infection pathways; thus these 3 diseases are recommended to be tested at the same time. However, this combined approach is currently mainly available in laboratories, and seldomly at the Point-of-care (POC). Consequently, there is a need for a STI screening POC platform with laboratory-like performance. Such a platform should be autonomous and portable and enable multiplexed screening from capillary blood. The previously developed and introduced MLFIA (Magnetically Localized and wash-free Fluorescent Immuno-Assay) technology has the potential to address these needs, as the MLFIA 18-chamber microfluidic cartridge and the MLFIA Analyzer were previously characterized and evaluated with plasma and serum from patients infected with HIV, Hepatitis B (Hep B) or C (Hep C). Here, we present the efforts to transfer this research platform (MLFIA) to a fully integrated multi-analysis solution (MagIA). First, we present the design changes of the consumable enabling to perform multiple assays in parallel, a fast filling of the cartridge with patient samples, and a homogeneous reagent/sample incubation. Second, we describe the development a piezoelectric actuator integrated into the Analyzer: this mixing module allows for an automated, fully integrated and portable workflow, with homogeneous in-situ mixing capabilities. The obtained MagIA platform was further characterized and validated for immunoassays (LOD, cartridge stability over time), using various biological models including OVA and IgG. We discuss the performances of the MLFIA and MagIA platforms for the detection of HIV / Hep B / Hep C using results from 102 patient plasma samples. Lastly, we assessed the compatibility of the MagIA platform with veinous and capillary blood samples as a final step towards its POC validation.
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Affiliation(s)
- M Fratzl
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - P Bigotte
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - R Gorbenkov
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - G Goubet
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - P Halfon
- Hopital Europeen, Laboratoire Alphabio-Biogroup, Marseille 13003, France
| | - P Kauffmann
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - D Kirk
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - V Masse
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - X Payet-Burin
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - O Ramel
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - S Delshadi
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France.
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22
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Thomadakis C, Basoulis D, Tsachouridou O, Protopapas K, Paparizos V, Astriti M, Chini M, Chrysos G, Marangos M, Panagopoulos P, Kofteridis D, Sambatakou H, Mastrogianni E, Panatzis N, Pechlivanidou E, Psichοgiou M, Touloumi G. HCV Cascade of Care in HIV/HCV Co-Infected Individuals: Missed Opportunities for Micro-Elimination. Viruses 2024; 16:885. [PMID: 38932178 PMCID: PMC11209384 DOI: 10.3390/v16060885] [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: 04/08/2024] [Revised: 05/17/2024] [Accepted: 05/28/2024] [Indexed: 06/28/2024] Open
Abstract
People living with HIV-HCV co-infection comprise a target group for HCV-micro-elimination. We conducted an HCV cascade of care (CoC) for HIV-HCV co-infected individuals living in Greece and investigated factors associated with different HCV-CoC stages. We analyzed data from 1213 participants from the Athens Multicenter AIDS Cohort Study. A seven-stage CoC, overall and by subgroup (people who inject drugs (PWID), men having sex with men (MSM), men having sex with women (MSW), and migrants], was constructed, spanning from HCV diagnosis to sustained virologic response (SVR). Logistic/Cox regression models were employed to identify factors associated with passing through each CoC step. Among 1213 anti-HCV-positive individuals, 9.2% died before direct-acting antiviral (DAA) availability. PWID exhibited higher mortality rates than MSM. Of 1101 survivors, 72.2% remained in care and underwent HCV-RNA testing. Migrants and PWID showed the lowest retention rates. HCV-RNA was available for 79.2% of those in care, with 77.8% diagnosed with chronic HCV. Subsequently, 71% initiated DAAs, with individuals with very low CD4 counts (<100 cells/μL) exhibiting lower odds of DAA initiation. SVR testing was available for 203 individuals, with 85.7% achieving SVR. The SVR rates did not differ across risk groups. In 2023, significant gaps and between-group differences persisted in HCV-CoC among HIV-HCV co-infected individuals in Greece.
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Affiliation(s)
- Christos Thomadakis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (C.T.); (N.P.); (E.P.)
| | - Dimitrios Basoulis
- 1st Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (D.B.); (E.M.); (M.P.)
| | - Olga Tsachouridou
- Infectious Diseases Unit, 1st Internal Medicine Department, AHEPA University Hospital, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece;
| | - Konstantinos Protopapas
- 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, 124 62 Athens, Greece;
| | - Vasilios Paparizos
- AIDS Unit, Clinic of Venereologic & Dermatologic Diseases, Medical School, Syngros Hospital, National and Kapodistrian University of Athens, 161 21 Athens, Greece;
| | - Myrto Astriti
- 1st Department of Internal Medicine and Infectious Diseases Unit, General Hospital of Athens G. Gennimatas, 115 27 Athens, Greece;
| | - Maria Chini
- 3rd Department of Internal Medicine Infectious Diseases Unit, Red Cross General Hospital, 115 26 Athens, Greece;
| | - Georgios Chrysos
- Infectious Diseases Unit, Tzaneion General Hospital of Piraeus, 185 36 Athens, Greece;
| | - Markos Marangos
- Department of Internal Medicine & Infectious Diseases, Patras University General Hospital, 265 04 Patras, Greece;
| | - Periklis Panagopoulos
- Infectious Diseases Unit, 2nd University Department of Internal Medicine, University Hospital of Alexandroupolis, Democritus University of Thrace, 681 00 Alexandroupolis, Greece;
| | - Diamantis Kofteridis
- Department of Internal Medicine, University Hospital of Heraklion, 715 00 Heraklion, Greece;
| | - Helen Sambatakou
- HIV Unit, 2nd Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Hippokration University General Hospital, 115 27 Athens, Greece;
| | - Elpida Mastrogianni
- 1st Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (D.B.); (E.M.); (M.P.)
| | - Nikos Panatzis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (C.T.); (N.P.); (E.P.)
| | - Evmorfia Pechlivanidou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (C.T.); (N.P.); (E.P.)
| | - Mina Psichοgiou
- 1st Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (D.B.); (E.M.); (M.P.)
| | - Giota Touloumi
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (C.T.); (N.P.); (E.P.)
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23
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Dobrowolska K, Brzdęk M, Rzymski P, Flisiak R, Pawłowska M, Janczura J, Brzdęk K, Zarębska-Michaluk D. Revolutionizing hepatitis C treatment: next-gen direct-acting antivirals. Expert Opin Pharmacother 2024; 25:833-852. [PMID: 38768013 DOI: 10.1080/14656566.2024.2358139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 05/17/2024] [Indexed: 05/22/2024]
Abstract
INTRODUCTION With the introduction of highly effective and safe therapies with next-generation direct-acting antivirals (DAAs), that act without interferon, hepatitis C virus (HCV) infection remains the only treatable chronic infectious disease. AREAS COVERED The review aims to provide an overview of the therapy revolution with a description of specific DAAs, their mechanisms of action, a summary of the safety and efficacy of specific regimens, and a discussion of populations requiring special therapeutic approaches. EXPERT OPINION DAAs are highly effective, safe, and easy to use. However, challenges such as access to health services and loss of patients from the cascade of care, especially in groups disproportionately affected by HCV infection, such as substance abusers, make it difficult to achieve the WHO's goal of HCV elimination. The proposed strategy to combat these difficulties involves a one-step approach to diagnosing and treating the infection, the availability of long-lasting forms of medication, and the development of an effective vaccine. The aforementioned opportunities are all the more important as the world is facing an opioid epidemic that is translating into an increase in HCV prevalence. This phenomenon is of greatest concern in women of childbearing age and in those already pregnant due to treatment limitations.
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Affiliation(s)
| | - Michał Brzdęk
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | - Piotr Rzymski
- Department of Environmental Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Białystok, Białystok, Poland
| | - Małgorzata Pawłowska
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland
| | - Jakub Janczura
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | - Kinga Brzdęk
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
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24
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Turk T, Labarile M, Braun DL, Rauch A, Stöckle M, Cavassini M, Hoffmann M, Calmy A, Bernasconi E, Notter J, Pasin C, Günthard HF, Kouyos RD. Characterization and Determinants of Long-Term Immune Recovery Under Suppressive Antiretroviral Therapy. J Acquir Immune Defic Syndr 2024; 96:68-76. [PMID: 38301637 DOI: 10.1097/qai.0000000000003388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/20/2023] [Indexed: 02/03/2024]
Abstract
OBJECTIVE We developed a robust characterization of immune recovery trajectories in people living with HIV on antiretroviral treatment (ART) and relate our findings to epidemiological risk factors and bacterial pneumonia. METHODS Using data from the Swiss HIV Cohort Study and the Zurich Primary HIV Infection Cohort Study (n = 5907), we analyzed the long-term trajectories of CD4 cell and CD8 cell counts and their ratio in people living with HIV on ART for at least 8 years by fitting nonlinear mixed-effects models. The determinants of long-term immune recovery were investigated using generalized additive models. In addition, prediction accuracy of the modeled trajectories and their impact on the fit of a model for bacterial pneumonia was assessed. RESULTS Overall, our population showed good immune recovery (median plateau [interquartile range]-CD4: 718 [555-900] cells/μL, CD8: 709 [547-893] cells/μL, CD4/CD8: 1.01 [0.76-1.37]). The following factors were predictive of recovery: age, sex, nadir/zenith value, pre-ART HIV-1 viral load, hepatitis C, ethnicity, acquisition risk, and timing of ART initiation. The fitted models proved to be an accurate and efficient way of predicting future CD4 and CD8 cell recovery dynamics: Compared with carrying forward the last observation, mean squared errors of the fitted values were lower by 1.3%-18.3% across outcomes. When modeling future episodes of bacterial pneumonia, using predictors derived from the recovery dynamics improved most model fits. CONCLUSION We described and validated a method to characterize individual immune recovery trajectories of people living with HIV on suppressive ART. These trajectories accurately predict long-term immune recovery and the occurrence of bacterial pneumonia.
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Affiliation(s)
- Teja Turk
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Marco Labarile
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Dominique L Braun
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Andri Rauch
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Marcel Stöckle
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Matthias Cavassini
- Division of Infectious Diseases, Lausanne University Hospital, Lausanne, Switzerland
| | - Matthias Hoffmann
- Clinic for Infectious Diseases, Cantonal Hospital Olten, Olten, Switzerland
| | - Alexandra Calmy
- Division of Infectious Diseases, Geneva University Hospital, Geneva, Switzerland
| | - Enos Bernasconi
- Division of Infectious Diseases, Ente Ospedaliero Cantonale, Lugano, Switzerland
- University of Geneva and University of Southern Switzerland, Lugano, Switzerland
| | - Julia Notter
- Division of Infectious Diseases, Cantonal Hospital St. Gallen, St. Gallen, Switzerland ; and
| | | | - Huldrych F Günthard
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Roger D Kouyos
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
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25
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Saeed S, Thomas T, Dinh DA, Moodie E, Cox J, Cooper C, Gill J, Martel-Laferriere V, Panagiotoglou D, Walmsley S, Wong A, Klein MB. Frequent Disengagement and Subsequent Mortality Among People With HIV and Hepatitis C in Canada: A Prospective Cohort Study. Open Forum Infect Dis 2024; 11:ofae239. [PMID: 38798898 PMCID: PMC11127478 DOI: 10.1093/ofid/ofae239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 04/23/2024] [Indexed: 05/29/2024] Open
Abstract
Background The cascade of care, commonly used to assess HIV and hepatitis C (HCV) health service delivery, has limitations in capturing the complexity of individuals' engagement patterns. This study examines the dynamic nature of engagement and mortality trajectories among people with HIV and HCV. Methods We used data from the Canadian HIV-HCV Co-Infection Cohort, which prospectively follows 2098 participants from 18 centers biannually. Markov multistate models were used to evaluate sociodemographic and clinical factors associated with transitioning between the following states: (1) lost-to-follow-up (LTFU), defined as no visit for 18 months; (2) reengaged (reentry into cohort after being LTFU); (3) withdrawn from the study (ie, moved); (4) death; otherwise remained (5) engaged-in-care. Results A total of 1809 participants met the eligibility criteria and contributed 12 591 person-years from 2003 to 2022. LTFU was common, with 46% experiencing at least 1 episode, of whom only 57% reengaged. One in 5 (n = 383) participants died during the study. Participants who transitioned to LTFU were twice as likely to die as those who were consistently engaged. Factors associated with transitioning to LTFU included detectable HCV RNA (adjusted hazards ratio [aHR], 1.37; 95% confidence interval [CI], 1.13-1.67), evidence of HCV treatment but no sustained virologic response result (aHR, 1.99; 95% CI, 1.56-2.53), and recent incarceration (aHR, 1.94; 95% CI, 1.58-2.40). Being Indigenous was a significant predictor of death across all engagement trajectories. Interpretation Disengagement from clinical care was common and resulted in higher death rates. People LTFU were more likely to require HCV treatment highlighting a priority population for elimination strategies.
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Affiliation(s)
- Sahar Saeed
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Tyler Thomas
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Duy A Dinh
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Erica Moodie
- School of Population and Global Health, McGill University, Montreal, Quebec, Canada
| | - Joseph Cox
- School of Population and Global Health, McGill University, Montreal, Quebec, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Curtis Cooper
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - John Gill
- Department of Medicine, Centre de recherche du Centre hospitalier de l'Université Montréal, Montreal, Quebec, Canada
| | - Valerie Martel-Laferriere
- Department of Medicine, Centre de recherche du Centre hospitalier de l'Université Montréal, Montreal, Quebec, Canada
| | | | - Sharon Walmsley
- Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Alexander Wong
- Department of Medicine, Regina Qu’Appelle Health Region, Regina, Saskatchewan, Canada
| | - Marina B Klein
- Department of Medicine, Division of Infectious Diseases/Chronic Viral Illness Service, McGill University Health Center, Quebec, Canada
- Canadian HIV Trials Network, Vancouver, British Columbia, Canada
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Jose-Abrego A, Trujillo-Trujillo ME, Laguna-Meraz S, Roman S, Panduro A. Epidemiology of Hepatitis C Virus in HIV Patients from West Mexico: Implications for Controlling and Preventing Viral Hepatitis. Pathogens 2024; 13:360. [PMID: 38787212 PMCID: PMC11123714 DOI: 10.3390/pathogens13050360] [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] [Received: 02/28/2024] [Revised: 04/24/2024] [Accepted: 04/24/2024] [Indexed: 05/25/2024] Open
Abstract
The complex epidemiology of hepatitis C virus (HCV) infection among human immunodeficiency virus (HIV) patients in West Mexico remains poorly understood. Thus, this study aimed to investigate the HCV prevalence, HCV-associated risk factors, and HCV genotypes/subtypes and assess their impacts on liver fibrosis in 294 HIV patients (median age: 38 years; 88.1% male). HCV RNA was extracted and amplified by PCR. Hepatic fibrosis was assessed using three noninvasive methods: transient elastography (TE), the aspartate aminotransferase (AST)-to-platelets ratio index score (APRI), and the fibrosis-4 score (FIB4). Patients with liver stiffness of ≥9.3 Kpa were considered to have advanced liver fibrosis. HCV genotypes/subtypes were determined by line probe assay (LiPA) or Sanger sequencing. The prevalence of HIV/HCV infection was 36.4% and was associated with injection drug use (odds ratio (OR) = 13.2; 95% confidence interval (CI) = 5.9-33.6; p < 0.001), imprisonment (OR = 3.0; 95% CI = 1.7-5.4; p < 0.001), the onset of sexual life (OR = 2.6; 95% CI = 1.5-4.5; p < 0.001), blood transfusion (OR = 2.5; 95% CI = 1.5-4.2; p = 0.001), tattooing (OR = 2.4; 95% CI = 1.4-3.9; p = 0.001), being a sex worker (OR = 2.3; 95% CI = 1.0-5.4; p = 0.046), and surgery (OR = 1.7; 95% CI = 1.0-2.7; p = 0.042). The HCV subtype distribution was 68.2% for 1a, 15.2% for 3a, 10.6% for 1b, 3.0% for 2b, 1.5% for 2a, and 1.5% for 4a. The advanced liver fibrosis prevalence was highest in patients with HIV/HCV co-infection (47.7%), especially in those with HCV subtype 1a. CD4+ counts, albumin, direct bilirubin, and indirect bilirubin were associated with liver fibrosis. In conclusion, HCV infection had a significant impact on the liver health of Mexican HIV patients, highlighting the need for targeted preventive strategies in this population.
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Affiliation(s)
- Alexis Jose-Abrego
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, “Fray Antonio Alcalde”, Guadalajara 44280, Jalisco, Mexico; (A.J.-A.); (M.E.T.-T.); (S.L.-M.); (S.R.)
- Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Maria E. Trujillo-Trujillo
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, “Fray Antonio Alcalde”, Guadalajara 44280, Jalisco, Mexico; (A.J.-A.); (M.E.T.-T.); (S.L.-M.); (S.R.)
- Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Saul Laguna-Meraz
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, “Fray Antonio Alcalde”, Guadalajara 44280, Jalisco, Mexico; (A.J.-A.); (M.E.T.-T.); (S.L.-M.); (S.R.)
- Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Sonia Roman
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, “Fray Antonio Alcalde”, Guadalajara 44280, Jalisco, Mexico; (A.J.-A.); (M.E.T.-T.); (S.L.-M.); (S.R.)
- Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Arturo Panduro
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, “Fray Antonio Alcalde”, Guadalajara 44280, Jalisco, Mexico; (A.J.-A.); (M.E.T.-T.); (S.L.-M.); (S.R.)
- Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
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Ocampo FF, Sacdalan C, Pinyakorn S, Paudel M, Wansom T, Poltubtim N, Sriplienchan S, Phanuphak N, Paul R, Hsu D, Colby D, Trautmann L, Spudich S, Chan P. Neuropsychiatric and Laboratory Outcomes of Hepatitis C Treatment in an Early-Treated HIV Cohort in Thailand. RESEARCH SQUARE 2024:rs.3.rs-4186965. [PMID: 38645141 PMCID: PMC11030515 DOI: 10.21203/rs.3.rs-4186965/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Background Hepatitis C virus (HCV) coinfection may further compromise immunological and cognitive function in people with HIV (PWH). This study compared laboratory and neuropsychiatric measures across the periods of HCV seroconversion and direct-acting antiviral (DAA) therapy with sustained virologic response (SVR) among PWH who initiated antiretroviral therapy (ART) during acute HIV infection (AHI) and acquired HCV after 24 weeks of ART. Methods Participants from the RV254 AHI cohort underwent paired laboratory and neuropsychiatric assessments during regular follow-up. The former included measurements of CD4 + and CD8 + T-cell counts, HIV RNA, liver enzymes, and lipid profiles. The latter included the Patient Health Questionnaire-9 (PHQ-9), Distress Thermometer (DT), and a 4-test cognitive battery that evaluated psychomotor speed, executive function, fine motor speed and dexterity. The raw scores in the battery were standardized and averaged to create an overall performance (NPZ-4) score. Parameters of HCV-coinfected participants were compared across HCV seroconversion and DAA treatment groups. Results Between 2009 and 2022, 79 of 703 RV254 participants acquired HCV after ≥ 24 weeks of ART; 53 received DAA, and 50 (94%) achieved SVR. All participants were Thai males (median age: 30 years); 34 (68%) denied past intravenous drug use, and 41 (82%) had a history of other sexually transmitted infections during follow-up. Following SVR, aspartate transferase (AST) and alanine transaminase (ALT) decreased (p < 0.001), while total cholesterol, low-density lipoprotein, and triglycerides increased (p < 0.01). The median CD4+/CD8 + ratio increased from 0.91 to 0.97 (p = 0.012). NPZ-4 improved from 0.75 to 0.91 (p = 0.004). The median DT score increased from 1.7 to 2.7 (p = 0.045), but the PHQ-9 score remained unchanged. Conclusion HCV coinfection is common in this group of high-risk PWH, highlighting the need for regular screening, early diagnosis, and treatment. There was a modest improvement in the CD4+/CD8 + T-cell ratio and cognitive performance after DAA therapy in patients who achieved SVR. Future studies should examine potential neuropsychiatric impacts during early HCV infection as well as the longer-term neuropsychiatric outcomes after DAA treatment with SVR.
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López CAM, Freiberger RN, Sviercz FA, Jarmoluk P, Cevallos C, Quarleri J, Delpino MV. HIV and gp120-induced lipid droplets loss in hepatic stellate cells contribute to profibrotic profile. Biochim Biophys Acta Mol Basis Dis 2024; 1870:167084. [PMID: 38368823 DOI: 10.1016/j.bbadis.2024.167084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 01/24/2024] [Accepted: 02/12/2024] [Indexed: 02/20/2024]
Abstract
Liver fibrosis is the excessive accumulation of extracellular matrix proteins, primarily collagen, in response to liver injury caused by chronic liver diseases. HIV infection accelerates the progression of liver fibrosis in patients co-infected with HCV or HBV compared to those who are only mono-infected. The early event in the progression of liver fibrosis involves the activation of hepatic stellate cells (HSCs), which entails the loss of lipid droplets (LD) to fuel the production of extracellular matrix components crucial for liver tissue healing. Thus, we are examining the mechanism by which HIV stimulates the progression of liver fibrosis. HIV-R5 tropic infection was unable to induce the expression of TGF-β, collagen deposition, α-smooth muscle actin (α-SMA), and cellular proliferation. However, this infection induced the secretion of the profibrogenic cytokine IL-6 and the loss of LD. This process involved the participation of peroxisome proliferator-activated receptor (PPAR)-α and an increase in lysosomal acid lipase (LAL), along with the involvement of Microtubule-associated protein 1 A/1B-light chain 3 (LC3), strongly suggesting that LD loss could occur through acid lipolysis. These phenomena were mimicked by the gp120 protein from the R5 tropic strain of HIV. Preincubation of HSCs with the CCR5 receptor antagonist, TAK-779, blocked gp120 activity. Additionally, experiments performed with pseudotyped-HIV revealed that HIV replication could also contribute to LD loss. These results demonstrate that the cross-talk between HSCs and HIV involves a series of interactions that help explain some of the mechanisms involved in the exacerbation of liver damage observed in co-infected individuals.
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Affiliation(s)
- Cinthya Alicia Marcela López
- Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS), Facultad de Medicina, Consejo de Investigaciones Científicas y Técnicas (CONICET), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Rosa Nicole Freiberger
- Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS), Facultad de Medicina, Consejo de Investigaciones Científicas y Técnicas (CONICET), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Franco Agustín Sviercz
- Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS), Facultad de Medicina, Consejo de Investigaciones Científicas y Técnicas (CONICET), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Patricio Jarmoluk
- Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS), Facultad de Medicina, Consejo de Investigaciones Científicas y Técnicas (CONICET), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Cintia Cevallos
- Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS), Facultad de Medicina, Consejo de Investigaciones Científicas y Técnicas (CONICET), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Jorge Quarleri
- Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS), Facultad de Medicina, Consejo de Investigaciones Científicas y Técnicas (CONICET), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - María Victoria Delpino
- Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS), Facultad de Medicina, Consejo de Investigaciones Científicas y Técnicas (CONICET), Universidad de Buenos Aires, Buenos Aires, Argentina.
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Gutstein L, Arevalo M, Reich RR, Fan W, Vadaparampil ST, Meade CD, Abdulla R, Lawrence E, Roetzheim RG, Lopez D, Collier A, Deak E, Ewing AP, Gwede CK, Christy SM. Factors associated with prior completion of colorectal cancer and hepatitis C virus screenings among community health center patients: a cross-sectional study to inform a multi-behavioral educational intervention. J Behav Med 2024; 47:295-307. [PMID: 38127175 PMCID: PMC11635817 DOI: 10.1007/s10865-023-00460-4] [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: 02/14/2023] [Accepted: 10/17/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Colorectal cancer (CRC) and liver cancer are two of the leading causes of cancer death in the United States and persistent disparities in CRC and liver cancer incidence and outcomes exist. Chronic hepatitis C virus (HCV) infection is one of the main contributors to liver cancer. Effective screening for both CRC and HCV exist and are recommended for individuals based upon age, regardless of gender or sex assigned at birth. Recommendations for both screening behaviors have been recently updated. However, screening rates for both CRC and HCV are suboptimal. Targeting adoption of multiple screening behaviors has the potential to reduce cancer mortality and disparities. OBJECTIVE To examine psychosocial factors associated with completion of CRC and HCV screenings in order to inform a multi-behavioral educational intervention that pairs CRC and HCV screening information. METHODS A cross-sectional survey was conducted with participants (N = 50) recruited at two community health centers in Florida (United States). Kruskal-Wallis and Fisher's exact tests were used to examine associations between completion of both CRC and HCV screening, CRC and HCV knowledge, Preventive Health Model constructs (e.g., salience and coherence, response efficacy, social influence), and sociodemographic variables. RESULTS Most participants were White (84%), female (56%), insured (80%), and reported a household income of $25,000 or less (53%). 30% reported ever previously completing both CRC and HCV screenings. Prior completion of both screening behaviors was associated with higher educational attainment (p = .014), having health insurance (p = .022), being U.S.-born (p = .043), and higher salience and coherence scores for CRC (p = .040) and HCV (p = .004). CONCLUSIONS Findings demonstrate limited uptake of both CRC and HCV screenings among adults born between 1945 and 1965. Uptake was associated with multiple sociodemographic factors and health beliefs related to salience and coherence. Salience and coherence are modifiable factors associated with completion of both screening tests, suggesting the importance of incorporating these health beliefs in a multi-behavioral cancer education intervention. Additionally, health providers could simultaneously recommend and order CRC and HCV screening to improve uptake among this age cohort.
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Affiliation(s)
- Lila Gutstein
- Morsani School of Medicine, University of South Florida, 12901 Bruce B. Downs Blvd., Tampa, FL, 33612, USA
| | - Mariana Arevalo
- Department of Health Outcomes & Behavior, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA
| | - Richard R Reich
- Biostatistics and Bioinformatics Shared Resources, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA
| | - Wenyi Fan
- Biostatistics and Bioinformatics Shared Resources, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA
| | - Susan T Vadaparampil
- Morsani School of Medicine, University of South Florida, 12901 Bruce B. Downs Blvd., Tampa, FL, 33612, USA
- Department of Health Outcomes & Behavior, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA
| | - Cathy D Meade
- Morsani School of Medicine, University of South Florida, 12901 Bruce B. Downs Blvd., Tampa, FL, 33612, USA
- Department of Health Outcomes & Behavior, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA
| | - Rania Abdulla
- Non-Therapeutic Research Office, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA
| | - Elizabeth Lawrence
- Turley Family Care Center, Baycare, 807 N. Myrtle Ave., Clearwater, FL, 33755, USA
| | - Richard G Roetzheim
- Morsani School of Medicine, University of South Florida, 12901 Bruce B. Downs Blvd., Tampa, FL, 33612, USA
| | - Diana Lopez
- Suncoast Community Health Center, 313 S Lakewood Dr., Brandon, FL, 33511, USA
| | - Aaron Collier
- Formerly with Moffitt Cancer Center, Tampa, FL, 33612, USA
| | - Emalyn Deak
- Formerly with Moffitt Cancer Center, Tampa, FL, 33612, USA
| | - Aldenise P Ewing
- College of Public Health, The Ohio State University, 1841 Neil Ave., Building 293 Cunz Hall, Columbus, OH, 43210, USA
| | - Clement K Gwede
- Morsani School of Medicine, University of South Florida, 12901 Bruce B. Downs Blvd., Tampa, FL, 33612, USA
- Department of Health Outcomes & Behavior, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA
| | - Shannon M Christy
- Morsani School of Medicine, University of South Florida, 12901 Bruce B. Downs Blvd., Tampa, FL, 33612, USA.
- Department of Health Outcomes & Behavior, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA.
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30
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Falade-Nwulia O, Lesko CR, Fojo AT, Keruly JC, Moore RD, Sutcliffe CG, Mehta SH, Chander G, Thomas DL, Sulkowski M. Hepatitis C Treatment in People With HIV: Potential to Eliminate Disease and Disparity. J Infect Dis 2024; 229:775-779. [PMID: 37793170 PMCID: PMC10938212 DOI: 10.1093/infdis/jiad433] [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: 05/21/2023] [Revised: 09/20/2023] [Accepted: 10/02/2023] [Indexed: 10/06/2023] Open
Abstract
Access to direct acting antivirals (DAAs) may be associated with reductions in hepatitis C virus (HCV) viremia prevalence among people with human immunodeficiency virus (PWH). Among 3755 PWH, estimated HCV viremia prevalence decreased by 94.0% from 36% (95% confidence interval [CI], 27%-46%) in 2009 (pre-DAA era) to 2% (95% CI, 0%-4%) in 2021 (DAA era). Male sex, black race, and older age were associated with HCV viremia in 2009 but not in 2021. Injection drug use remained associated with HCV viremia in 2009 and 2021. Targeted interventions are needed to meet the HCV care needs of PWH who use drugs.
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Affiliation(s)
- Oluwaseun Falade-Nwulia
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Catherine R Lesko
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Anthony T Fojo
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jeanne C Keruly
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Richard D Moore
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Catherine G Sutcliffe
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Shruti H Mehta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Geetanjali Chander
- Division of General Internal Medicine, University of Washington, Seattle, Washington, USA
| | - David L Thomas
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mark Sulkowski
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Bravo CA, Moon JY, Davy K, Kaplan RC, Anastos K, Rodriguez CJ, Post WS, Gange SJ, Kassaye SG, Kingsley LA, Lazar JM, Mack WJ, Pyslar N, Tien PC, Witt MD, Palella FJ, Li Y, Yan M, Hodis HN, Hanna DB. Association of HIV and HCV Infection With Carotid Artery Plaque Echomorphology in the MACS/WIHS Combined Cohort Study. Stroke 2024; 55:651-659. [PMID: 38333992 PMCID: PMC10940210 DOI: 10.1161/strokeaha.123.043922] [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: 05/17/2023] [Accepted: 12/19/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND HIV and hepatitis C virus (HCV) are associated with increased risk of carotid artery atherosclerotic plaque and stroke. We examined associations of HIV- and HCV-related factors with echomorphologic features of carotid artery plaque. METHODS This cross-sectional study included participants from the MACS (Multicenter AIDS Cohort Study)/WIHS (Women's Interagency HIV Study) Combined Cohort Study who underwent high-resolution B-mode carotid artery ultrasound. Plaques were characterized from 6 areas of the right carotid artery. Poisson regression controlling for demographic and cardiometabolic risk factors determined adjusted prevalence ratios (aPRs) and 95% CIs for associations of HIV- and HCV-related factors with echomorphologic features. RESULTS Of 2655 participants (65% women, median age 44 [interquartile range, 37-50] years), 1845 (70%) were living with HIV, 600 (23%) were living with HCV, and 425 (16%) had carotid plaque. There were 191 plaques identified in 129 (11%) women with HIV, 51 plaques in 32 (7%) women without HIV, 248 plaques in 171 (28%) men with HIV, and 139 plaques in 93 (29%) men without HIV. Adjusted analyses showed that people with HIV and current CD4+ count <200 cells/µL had a significantly higher prevalence of predominantly echolucent plaque (aPR, 1.86 [95% CI, 1.08-3.21]) than those without HIV. HCV infection alone (aPR, 1.86 [95% CI, 1.08-3.19]) and HIV-HCV coinfection (aPR, 1.75 [95% CI, 1.10-2.78]) were each associated with higher prevalence of predominantly echogenic plaque. HIV-HCV coinfection was also associated with higher prevalence of smooth surface plaque (aPR, 2.75 [95% CI, 1.03-7.32]) compared with people without HIV and HCV. CONCLUSIONS HIV with poor immunologic control, as well as HCV infection, either alone or in the presence of HIV, were associated with different echomorphologic phenotypes of carotid artery plaque.
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Affiliation(s)
| | | | | | - Robert C. Kaplan
- Albert Einstein College of Medicine, Bronx, NY, USA
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | | | - Wendy S. Post
- Johns Hopkins University, School of Medicine, Baltimore, MD, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Stephen J. Gange
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | - Jason M. Lazar
- State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Wendy J. Mack
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Phyllis C. Tien
- University of California-San Francisco and Department of Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Mallory D. Witt
- Lundquist Institute for Biomedical Research at Harbor-UCLA Medical Center, Los Angeles, CA, USA
| | - Frank J. Palella
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Yanjie Li
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Mingzhu Yan
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Howard N. Hodis
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Wegener M, Brooks R, Speers S, Nichols L, Villanueva M. Implementing a Surveillance-Based Approach to Create a Statewide Viral Clearance Cascade for Hepatitis C Among People With HIV and HCV Coinfection in Connecticut. Public Health Rep 2024; 139:208-217. [PMID: 37232422 PMCID: PMC10851907 DOI: 10.1177/00333549231172173] [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] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVES Highly effective direct-acting antiviral medications have made it feasible to achieve elimination of hepatis C virus (HCV), including for people with HIV and HCV coinfection. The Centers for Disease Control and Prevention offers guidance for a laboratory surveillance-based HCV viral clearance cascade, which allows public health departments to track the outcomes of people with HCV based on the following steps: ever infected, virally tested, initial infection, and cured or cleared. We examined the feasibility of this approach among people with HIV and HCV coinfection in Connecticut. METHODS We matched an HIV surveillance database, which included cases from the enhanced HIV/AIDS Reporting System as of December 31, 2019, and the HCV surveillance database, the Connecticut Electronic Disease Surveillance System, to define a cohort of coinfected people. We used HCV laboratory results obtained from January 1, 2016, through August 3, 2020, to determine HCV status. RESULTS Of 1361 people who were ever infected with HCV as of December 31, 2019, 1256 (92.3%) received HCV viral testing, 865 of 1256 people tested (68.9%) were HCV infected, and 336 of 865 infected people (38.8%) were cleared or cured. People who had undetectable HIV viral loads at most recent HIV test (<200 copies/mL) were more likely than those with detectable HIV viral loads to achieve HCV cure (P = .02). CONCLUSIONS A surveillance-based approach that includes data based on the Centers for Disease Control and Prevention HCV viral clearance cascade is feasible to implement, can help track population-level outcomes longitudinally, and can help identify gaps to inform HCV elimination strategies.
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Affiliation(s)
| | - Ralph Brooks
- School of Medicine, Yale University, New Haven, CT, USA
| | - Suzanne Speers
- Connecticut Department of Public Health, Hartford, CT, USA
| | - Lisa Nichols
- School of Medicine, Yale University, New Haven, CT, USA
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MacIsaac MB, Whitton B, Anderson J, Cogger S, Vella-Horne D, Penn M, Weeks A, Elmore K, Pemberton D, Winter RJ, Papaluca T, Howell J, Hellard M, Stoové M, Wilson D, Pedrana A, Doyle JS, Clark N, Holmes JA, Thompson AJ. Point-of-care HCV RNA testing improves hepatitis C testing rates and allows rapid treatment initiation among people who inject drugs attending a medically supervised injecting facility. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 125:104317. [PMID: 38281385 DOI: 10.1016/j.drugpo.2024.104317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/27/2023] [Accepted: 01/01/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND To achieve hepatitis C virus (HCV) elimination targets, simplified care engaging people who inject drugs is required. We evaluated whether fingerstick HCV RNA point-of-care testing (PoCT) increased the proportion of clients attending a supervised injecting facility who were tested for hepatitis C. METHODS Prospective single-arm study with recruitment between 9 November 2020 and 28 January 2021 and follow-up to 31 July 2021. Clients attending the supervised injecting facility were offered HCV RNA testing using the Xpert® HCV Viral Load Fingerstick (Cepheid, Sunnyvale, CA) PoCT. Participants with a positive HCV RNA test were prescribed direct acting antiviral (DAA) therapy. The primary endpoint was the proportion of clients who engaged in HCV RNA PoCT, compared to a historical comparator group when venepuncture-based hepatitis C testing was standard of care. RESULTS Among 1618 clients who attended the supervised injecting facility during the study period, 228 (14%) engaged in PoCT. This was significantly higher than that observed in the historical comparator group (61/1,775, 3%; p < 0.001). Sixty-five (28%) participants were HCV RNA positive, with 40/65 (62%) receiving their result on the same day as testing. Sixty-one (94%) HCV RNA positive participants were commenced on DAA therapy; 14/61 (23%) started treatment on the same day as diagnosis. There was no difference in the proportion of HCV RNA positive participants commenced on treatment with DAA therapy when compared to the historical comparator group (61/65, 94% vs 22/26, 85%; p = 0.153). However, the median time to treatment initiation was significantly shorter in the PoCT cohort (2 days (IQR 1-20) vs 41 days (IQR 22-76), p < 0.001). Among participants who commenced treatment and had complete follow-up data available, 27/36 (75%) achieved hepatitis C cure. CONCLUSIONS HCV RNA PoCT led to a significantly higher proportion of clients attending a supervised injecting facility engaging in hepatitis C testing, whilst also reducing the time to treatment initiation.
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Affiliation(s)
- Michael B MacIsaac
- Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia; Faculty of Medicine, University of Melbourne, Parkville, Victoria, Australia
| | - Bradley Whitton
- Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
| | - Jenine Anderson
- Medically Supervised Injecting Room, North Richmond Community Health, Richmond, Victoria, Australia
| | - Shelley Cogger
- Medically Supervised Injecting Room, North Richmond Community Health, Richmond, Victoria, Australia
| | - Dylan Vella-Horne
- Medically Supervised Injecting Room, North Richmond Community Health, Richmond, Victoria, Australia
| | - Matthew Penn
- Medically Supervised Injecting Room, North Richmond Community Health, Richmond, Victoria, Australia
| | - Anthony Weeks
- Medically Supervised Injecting Room, North Richmond Community Health, Richmond, Victoria, Australia
| | - Kasey Elmore
- Medically Supervised Injecting Room, North Richmond Community Health, Richmond, Victoria, Australia
| | - David Pemberton
- Medically Supervised Injecting Room, North Richmond Community Health, Richmond, Victoria, Australia
| | - Rebecca J Winter
- Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia; Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Timothy Papaluca
- Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia; Faculty of Medicine, University of Melbourne, Parkville, Victoria, Australia
| | - Jessica Howell
- Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia; Faculty of Medicine, University of Melbourne, Parkville, Victoria, Australia
| | - Margaret Hellard
- Faculty of Medicine, University of Melbourne, Parkville, Victoria, Australia; Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia
| | - Mark Stoové
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia
| | - David Wilson
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Alisa Pedrana
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Infectious Diseases, The Alfred and Monash University, Melbourne, Victoria, Australia
| | - Joseph S Doyle
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Infectious Diseases, The Alfred and Monash University, Melbourne, Victoria, Australia
| | - Nicolas Clark
- Medically Supervised Injecting Room, North Richmond Community Health, Richmond, Victoria, Australia; Department of Addiction Medicine, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Jacinta A Holmes
- Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia; Faculty of Medicine, University of Melbourne, Parkville, Victoria, Australia
| | - Alexander J Thompson
- Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia; Faculty of Medicine, University of Melbourne, Parkville, Victoria, Australia.
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Yang R, Yuan R, Gui X, Ke H, Zhuang K, Hu H, Li L, Feng L, Yu X, Yan Y, Luo M. Characteristics of Hepatitis B Virus, Hepatitis C Virus, and Syphilis Coinfection in People With HIV/AIDS Contracted Through Different Sources: Retrospective Study. JMIR Public Health Surveill 2024; 10:e46750. [PMID: 38412004 PMCID: PMC10933743 DOI: 10.2196/46750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 09/28/2023] [Accepted: 01/23/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND The burden of hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis coinfections remains disproportionately high among people living with HIV/AIDS. Hubei province is located in central China, where there are distinct regional characteristics of the distribution of people living with HIV/AIDS acquired via diverse transmission routes and the AIDS epidemic itself. OBJECTIVE We aimed to estimate the magnitude of HBV, HCV, or syphilis coinfections among people living with HIV/AIDS with blood-borne transmission, which includes former paid blood donors, contaminated blood recipients, and intravenous drug users, as well as among people with sex-borne HIV transmission (including heterosexual people and men who have sex with men) and people with mother-to-child HIV transmission. METHODS From January 2010 to December 2020, people living with HIV/AIDS were tested for hepatitis B surface antigen (HBsAg), HCV antibodies, and syphilis-specific antibodies. The positive patients were further tested for HBV markers, HBV DNA, and HCV RNA, and received a rapid plasma reagin circle card test. All people living with HIV/AIDS were first divided into transmission groups (blood, sex, and mother-to-child); then, people with blood-borne HIV transmission were divided into former paid blood donors, contaminated blood recipients, and intravenous drug users, while people with sex-borne HIV transmission were divided into heterosexual people and men who have sex with men. RESULTS Among 6623 people living with HIV/AIDS, rates of chronic HCV infection were 80.3% (590/735) in former paid blood donors, 73.3% (247/337) in intravenous drug users, 57.1% (444/777) in contaminated blood recipients, 19.4% (21/108) in people with mother-to-child HIV transmission, 8.1% (240/2975) in heterosexual people, and 1.2% (21/1691) in men who have sex with men. Chronic HBV infection rates were similar among all people with blood-borne HIV transmission. However, compared to heterosexual people, the chronic HBV infection rate was greater in men who have sex with men (213/1691, 12.6% vs 308/2975, 10.4%; χ21=5.469; P=.02), although HBV exposure was less common (827/1691, 48.9% vs 1662/2975, 55.9%; χ21=20.982; P<.001). Interestingly, the combination of HBsAg and hepatitis B e antigen (HBeAg) was found in 11 patients with sex-borne HIV transmission, but in 0 people with blood-borne HIV transmission (11/196, 5.6% vs 0/521, 0%; χ21=29.695, P<.001). In people with sex-borne HIV transmission, the proportions of patients with a syphilis titer ≥1:16 and neurosyphilis were 8.6% (105/1227) and 7.8% (37/473), respectively, whereas these values were 0 in people with blood-borne HIV transmission. CONCLUSIONS In people living with HIV/AIDS, HCV transmission intensity was significantly associated with specific exposure modes of blood or sexual contact. The rate of chronic HBV infection among men who have sex with men was higher than in any other population. Attention should be paid to the high prevalence of neurosyphilis in people living with HIV/AIDS who contract HIV by sexual intercourse.
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Affiliation(s)
- Rongrong Yang
- Zhongnan Hospital of Wuhan University, Wuhan, China
- Center for AIDS Research, Wuhan University, Wuhan, China
| | - Rui Yuan
- Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xien Gui
- Zhongnan Hospital of Wuhan University, Wuhan, China
- Center for AIDS Research, Wuhan University, Wuhan, China
| | - Hengning Ke
- Zhongnan Hospital of Wuhan University, Wuhan, China
- Center for AIDS Research, Wuhan University, Wuhan, China
| | - Ke Zhuang
- Animal Biosafety Level-III Laboratory at the Center for Animal Experiment, State Key Laboratory of Virology, Wuhan University, Wuhan, China
| | - Hui Hu
- Zhongnan Hospital of Wuhan University, Wuhan, China
- Center for AIDS Research, Wuhan University, Wuhan, China
| | - Ling Li
- Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Ling Feng
- Zhongnan Hospital of Wuhan University, Wuhan, China
- Center for AIDS Research, Wuhan University, Wuhan, China
| | - Xingxia Yu
- Department of Emergency, Renmin Hospital, Wuhan University, Wuhan, China
| | - Yajun Yan
- Zhongnan Hospital of Wuhan University, Wuhan, China
- Center for AIDS Research, Wuhan University, Wuhan, China
| | - Mingqi Luo
- Zhongnan Hospital of Wuhan University, Wuhan, China
- Center for AIDS Research, Wuhan University, Wuhan, China
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Goodman-Meza D, Shoptaw S, Hanscom B, Smith LR, Andrew P, Kuo I, Lake JE, Metzger D, Morrison EAB, Cummings M, Fogel JM, Richardson P, Harris J, Heitner J, Stansfield S, El-Bassel N. Delivering integrated strategies from a mobile unit to address the intertwining epidemics of HIV and addiction in people who inject drugs: the HPTN 094 randomized controlled trial protocol (the INTEGRA Study). Trials 2024; 25:124. [PMID: 38360750 PMCID: PMC10870682 DOI: 10.1186/s13063-023-07899-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 12/22/2023] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Persons with opioid use disorders who inject drugs (PWID) in the United States (US) face multiple and intertwining health risks. These include interference with consistent access, linkage, and retention to health care including medication for opioid use disorder (MOUD), HIV prevention using pre-exposure prophylaxis (PrEP), and testing and treatment for sexually transmitted infections (STIs). Most services, when available, including those that address substance misuse, HIV prevention, and STIs, are often provided in multiple locations that may be difficult to access, which further challenges sustained health for PWID. HPTN 094 (INTEGRA) is a study designed to test the efficacy of an integrated, "whole-person" strategy that provides integrated HIV prevention including antiretroviral therapy (ART), PrEP, MOUD, and STI testing and treatment from a mobile health delivery unit ("mobile unit") with peer navigation compared to peer navigation alone to access these services at brick and mortar locations. METHODS HPTN 094 (INTEGRA) is a two-arm, randomized controlled trial in 5 US cities where approximately 400 PWID without HIV are assigned either to an experimental condition that delivers 26 weeks of "one-stop" integrated health services combined with peer navigation and delivered in a mobile unit or to an active control condition using peer navigation only for 26 weeks to the same set of services delivered in community settings. The primary outcomes include being alive and retained in MOUD and PrEP at 26 weeks post-randomization. Secondary outcomes measure the durability of intervention effects at 52 weeks following randomization. DISCUSSION This trial responds to a need for evidence on using a "whole-person" strategy for delivering integrated HIV prevention and substance use treatment, while testing the use of a mobile unit that meets out-of-treatment PWID wherever they might be and links them to care systems and/or harm reduction services. Findings will be important in guiding policy for engaging PWID in HIV prevention or care, substance use treatment, and STI testing and treatment by addressing the intertwined epidemics of addiction and HIV among those who have many physical and geographic barriers to access care. TRIAL REGISTRATION ClinicalTrials.gov NCT04804072 . Registered on 18 March 2021.
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Affiliation(s)
- David Goodman-Meza
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, 10833 Le Conte Ave., CHS 52-215, Los Angeles, CA 90095-1688 USA
| | - Steven Shoptaw
- Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA USA
| | - Brett Hanscom
- Statistical Center for HIV/AIDS Research and Prevention (SCHARP), Seattle, WA USA
| | - Laramie R. Smith
- Division of Infectious Diseases and Global Public Health, University of California, San Diego, San Diego, CA USA
| | - Philip Andrew
- Family Health International (FHI 360), Durham, NC USA
| | - Irene Kuo
- Milken Institute School of Public Health Department of Epidemiology, George Washington University, Washington, DC, USA
| | | | - David Metzger
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
| | | | - Melissa Cummings
- Statistical Center for HIV/AIDS Research and Prevention, Fred Hutchinson Cancer Center, Seattle, WA USA
| | - Jessica M. Fogel
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Paul Richardson
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Jayla Harris
- Family Health International (FHI 360), Durham, NC USA
| | - Jesse Heitner
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA USA
| | - Sarah Stansfield
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA USA
| | | | - for the HPTN 094 Study Team
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, 10833 Le Conte Ave., CHS 52-215, Los Angeles, CA 90095-1688 USA
- Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA USA
- Statistical Center for HIV/AIDS Research and Prevention (SCHARP), Seattle, WA USA
- Division of Infectious Diseases and Global Public Health, University of California, San Diego, San Diego, CA USA
- Family Health International (FHI 360), Durham, NC USA
- Milken Institute School of Public Health Department of Epidemiology, George Washington University, Washington, DC, USA
- UTHealth-Houston, Houston, TX USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
- ICAP, Mailman School of Public Health, Columbia University, New York, NY USA
- Statistical Center for HIV/AIDS Research and Prevention, Fred Hutchinson Cancer Center, Seattle, WA USA
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD USA
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA USA
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA USA
- School of Social Work, Columbia University, New York, NY USA
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Kenfack-Momo R, Ngounoue MD, Kenmoe S, Takuissu GR, Ebogo-Belobo JT, Kengne-Ndé C, Mbaga DS, Zeuko’o Menkem E, Lontuo Fogang R, Tchatchouang S, Ndzie Ondigui JL, Kame-Ngasse GI, Kenfack-Zanguim J, Magoudjou-Pekam JN, Bowo-Ngandji A, Mahamat M, Nkie Esemu S, Ndip L, Njouom R. Global epidemiology of hepatitis C virus in dialysis patients: A systematic review and meta-analysis. PLoS One 2024; 19:e0284169. [PMID: 38330063 PMCID: PMC10852299 DOI: 10.1371/journal.pone.0284169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/25/2023] [Indexed: 02/10/2024] Open
Abstract
Dialysis is a replacement therapy for patients with End-Stage Renal Disease (ESRD). Patients on dialysis are at high risk of acquiring hepatitis C virus (HCV), which has become a leading cause of morbidity and mortality in this population. There is a wide range of prevalence of HCV in dialysis populations around the world. It is still unknown how prevalent HCV infection is among worldwide dialysis patients (including those undergoing hemodialysis and peritoneal dialysis). A review was conducted to estimate the global epidemiology of hepatitis C in dialysis patients. We searched PubMed, Excerpta Medica Database (Embase), Global Index Medicus and Web of Science until October 2022. A manual search of references from relevant articles was also conducted. Heterogeneity was evaluated by the χ2 test on Cochrane's Q statistic, and the sources of heterogeneity were investigated using subgroup analysis. In order to assess publication bias, funnel plots and Egger tests were conducted, and pooled HCV prevalence estimates were generated using a DerSimonian and Laird meta-analysis model. The study is registered with PROSPERO under CRD42022237789. We included 634 papers involving 392160 participants. The overall HCV case fatality rate was 38.7% (95% CI = 28.9-49). The global prevalence of HCV infection in dialysis population group were 24.3% [95% CI = 22.6-25.9]. As indicated by UNSD region, country, dialysis type, and HCV diagnostic targeted; Eastern Europe had the highest prevalence of 48.6% [95% CI = 35.2-62], Indonesia had 63.6% [95% CI = 42.9-82], hemodialysis patients had 25.5% [95% CI = 23.8-27.3], and anti-HCV were detected in 24.5% [95% CI = 22.8-26.2]. Dialysis patients, particularly those on hemodialysis, have a high prevalence and case fatality rate of HCV infection. Hemodialysis units need to implement strict infection control measures.
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Affiliation(s)
- Raoul Kenfack-Momo
- Department of Biochemistry, The University of Yaounde I, Yaounde, Cameroon
| | | | - Sebastien Kenmoe
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Guy Roussel Takuissu
- Centre for Food, Food Security and Nutrition Research, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | - Jean Thierry Ebogo-Belobo
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | - Cyprien Kengne-Ndé
- Epidemiological Surveillance, Evaluation and Research Unit, National AIDS Control Committee, Douala, Cameroon
| | | | | | | | | | | | - Ginette Irma Kame-Ngasse
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | | | | | - Arnol Bowo-Ngandji
- Department of Microbiology, The University of Yaounde I, Yaounde, Cameroon
| | - Maimouna Mahamat
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
- Hemodialysis Unit, Yaoundé General Hospital, Yaoundé, Cameroon
| | | | - Lucy Ndip
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Richard Njouom
- Virology Department, Centre Pasteur of Cameroon, Yaoundé, Cameroon
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37
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López CAM, Freiberger RN, Sviercz FA, Quarleri J, Delpino MV. HIV-Infected Hepatic Stellate Cells or HCV-Infected Hepatocytes Are Unable to Promote Latency Reversal among HIV-Infected Mononuclear Cells. Pathogens 2024; 13:134. [PMID: 38392872 PMCID: PMC10893349 DOI: 10.3390/pathogens13020134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/23/2024] [Accepted: 01/30/2024] [Indexed: 02/25/2024] Open
Abstract
Due to a common mode of transmission through infected human blood, hepatitis C virus (HCV) and human immunodeficiency virus (HIV) co-infection is relatively prevalent. In alignment with this, HCV co-infection is associated with an increased size of the HIV reservoir in highly active antiretroviral therapy (HAART)-treated individuals. Hence, it is crucial to comprehend the physiological mechanisms governing the latency and reactivation of HIV in reservoirs. Consequently, our study delves into the interplay between HCV/HIV co-infection in liver cells and its impact on the modulation of HIV latency. We utilized the latently infected monocytic cell line (U1) and the latently infected T-cell line (J-Lat) and found that mediators produced by the infection of hepatic stellate cells and hepatocytes with HIV and HCV, respectively, were incapable of inducing latency reversal under the studied conditions. This may favor the maintenance of the HIV reservoir size among latently infected mononuclear cells in the liver. Further investigations are essential to elucidate the role of the interaction between liver cells in regulating HIV latency and/or reactivation, providing a physiologically relevant model for comprehending reservoir microenvironments in vivo.
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Affiliation(s)
| | | | | | - Jorge Quarleri
- Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS), Facultad de Medicina, Consejo de Investigaciones Científicas y Técnicas (CONICET), Universidad de Buenos Aires, Buenos Aires 1121, Argentina; (C.A.M.L.); (R.N.F.)
| | - María Victoria Delpino
- Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS), Facultad de Medicina, Consejo de Investigaciones Científicas y Técnicas (CONICET), Universidad de Buenos Aires, Buenos Aires 1121, Argentina; (C.A.M.L.); (R.N.F.)
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38
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van Santen DK, Stewart A, Doyle JS, Stoové MA, Asselin J, Klein MB, Young J, Berenguer J, Jarrin I, Lacombe K, Wittkop L, Leleux O, Salmon D, Bonnet F, Rauch A, Mugglin C, Matthews G, Prins M, Smit C, Boyd A, van der Valk M, Sacks-Davis R, Hellard ME. Cohort Profile: International Collaboration on Hepatitis C Elimination in HIV Cohorts (InCHEHC). Int J Epidemiol 2024; 53:dyad154. [PMID: 38066671 PMCID: PMC10859136 DOI: 10.1093/ije/dyad154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 11/06/2023] [Indexed: 02/12/2024] Open
Affiliation(s)
- Daniela K van Santen
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC Australia
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Ashleigh Stewart
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC Australia
| | - Joseph S Doyle
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
- Department of Infectious Diseases, Alfred and Monash University, Melbourne, VIC, Australia
| | - Mark A Stoové
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC Australia
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
| | - Jason Asselin
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
| | - Marina B Klein
- Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada
| | - Jim Young
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Juan Berenguer
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Inmaculada Jarrin
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Instituto de Salud Carlos III, Madrid, Spain
| | - Karine Lacombe
- Sorbonne Université, Inserm, IPLESP, Paris, France
- St Antoine Hospital, APHP, Paris, France
| | - Linda Wittkop
- Univ. Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-EC 1401, Bordeaux, France
- CHU de Bordeaux, Service d’information médicale, INSERM, Institut Bergonié, CIC-EC 1401, Bordeaux, France
- INRIA SISTM team, Talence, France
| | - Olivier Leleux
- Univ. Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-EC 1401, Bordeaux, France
| | - Dominique Salmon
- Université Paris Descartes, Service Maladies Infectieuses et Tropicales, AP-HP, Hôpital Cochin, Paris, France
| | - Fabrice Bonnet
- Univ. Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-EC 1401, Bordeaux, France
- CHU de Bordeaux, Service d’information médicale, INSERM, Institut Bergonié, CIC-EC 1401, Bordeaux, France
- CHU de Bordeaux, Hôpital Saint-André, Service de Médecine Interne et Maladies Infectieuses, F-33000 Bordeaux, France
| | - Andri Rauch
- Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Catrina Mugglin
- Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Gail Matthews
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Maria Prins
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity (AII), Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute (APH), Amsterdam, The Netherlands
- Stichting HIV Monitoring, Amsterdam, The Netherlands
| | - Colette Smit
- Stichting HIV Monitoring, Amsterdam, The Netherlands
| | - Anders Boyd
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands
- Stichting HIV Monitoring, Amsterdam, The Netherlands
| | - Marc van der Valk
- Amsterdam Institute for Infection and Immunity (AII), Amsterdam, The Netherlands
- Stichting HIV Monitoring, Amsterdam, The Netherlands
- Amsterdam UMC location University of Amsterdam, Infectious Diseases, Amsterdam, The Netherlands
| | - Rachel Sacks-Davis
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Margaret E Hellard
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC Australia
- Department of Infectious Diseases, Alfred and Monash University, Melbourne, VIC, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
- Doherty Institute, University of Melbourne, Melbourne, VIC, Australia
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Baumann L, Braun DL, Cavassini M, Stoeckle M, Bernasconi E, Schmid P, Calmy A, Haerry D, Béguelin C, Fux CA, Wandeler G, Surial B, Rauch A. Long-term trends in hepatitis C prevalence, treatment uptake and liver-related events in the Swiss HIV Cohort Study. Liver Int 2024; 44:169-179. [PMID: 37850685 DOI: 10.1111/liv.15754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/15/2023] [Accepted: 09/19/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND AND AIMS Treatment for chronic hepatitis C virus (HCV) infections changed dramatically in the last decade. We assessed changes in the prevalence of replicating HCV infection, treatment uptake and liver-related morbidity and mortality in persons with HIV (PWH) and hepatitis C in the Swiss HIV cohort study. METHODS We included all cohort participants between 2002 and 2021. We assessed yearly prevalence of replicating HCV infection, overall and liver-related mortality, as well as the yearly incidence of liver-related events in persons with at least one documented positive HCV-RNA. RESULTS Of 14 652 participants under follow-up, 2294 had at least one positive HCV-RNA measurement. Of those, 1316 (57%) ever received an HCV treatment. Treatment uptake increased from 8.1% in 2002 to a maximum of 32.6% in 2016. Overall, prevalence of replicating HCV infection declined from 16.5% in 2004 to 1.3% in 2021. HCV prevalence declined from 63.2% to 7.1% in persons who inject drugs, and from 4.1% to 0.6% in men who have sex with men. Among the 2294 persons with replicating HCV infection, overall mortality declined from a maximum of 3.3 per 100 patient-years (PY) to 1.1 per 100 PY, and incidence of liver-related events decreased from 1.4/100 PY to 0.2/100 PY. CONCLUSIONS The introduction of DAA therapy was associated with a more than 10-fold reduction in prevalence of replicating HCV infection in PWH, approaching the estimates in the general population. Overall mortality and liver-related events declined substantially in persons living with HIV and hepatitis C.
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Affiliation(s)
- Lukas Baumann
- Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Dominique L Braun
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Matthias Cavassini
- Division of Infectious Diseases, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Marcel Stoeckle
- Division of Infectious Diseases and Hospital Epidemiology, University of Basel, Basel, Switzerland
| | - Enos Bernasconi
- Division of Infectious Diseases, Ente Ospedaliero Cantonale, Lugano, University of Geneva and University of Southern Switzerland, Lugano, Switzerland
| | - Patrick Schmid
- Division of Infectious Diseases, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Alexandra Calmy
- HIV/AIDS Unit, Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
| | | | - Charles Béguelin
- Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Division of Infectious Diseases, Regional Hospital Biel, Biel, Switzerland
| | - Christoph A Fux
- Division of Infectious Diseases and Infection Prevention, Cantonal Hospital Aarau, Aarau, Switzerland
| | - Gilles Wandeler
- Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Bernard Surial
- Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andri Rauch
- Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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40
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Wu S, Wang J, Chen Y. 'Prevalence of human immunodeficiency virus, syphilis, and hepatitis B and C virus infections in pregnant women: a systematic review and meta-analysis': author's response. Clin Microbiol Infect 2024; 30:145-146. [PMID: 37918509 DOI: 10.1016/j.cmi.2023.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 10/21/2023] [Indexed: 11/04/2023]
Affiliation(s)
- Shouyuan Wu
- Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Jianjian Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yaolong Chen
- Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences (2021RU0170), School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China.
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Balaji S, Chakraborty R, Aggarwal S. Neurological Complications Caused by Human Immunodeficiency Virus (HIV) and Associated Opportunistic Co-infections: A Review on their Diagnosis and Therapeutic Insights. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2024; 23:284-305. [PMID: 37005520 DOI: 10.2174/1871527322666230330083708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 12/28/2022] [Accepted: 01/25/2023] [Indexed: 04/04/2023]
Abstract
Neurocognitive disorders associated with human immunodeficiency virus (HIV) infected individuals increase the risk of mortality and morbidity that remain a prevalent clinical complication even in the antiretroviral therapy era. It is estimated that a considerable number of people in the HIV community are developing neurological complications at their early stages of infection. The daily lives of people with chronic HIV infections are greatly affected by cognitive declines such as loss of attention, learning, and executive functions, and other adverse conditions like neuronal injury and dementia. It has been found that the entry of HIV into the brain and subsequently crossing the blood-brain barrier (BBB) causes brain cell damage, which is the prerequisite for the development of neurocognitive disorders. Besides the HIV replication in the central nervous system and the adverse effects of antiretroviral therapy on the BBB, a range of opportunistic infections, including viral, bacterial, and parasitic agents, augment the neurological complications in people living with HIV (PLHIV). Given the immuno-compromised state of PLHIV, these co-infections can present a wide range of clinical syndromes with atypical manifestations that pose challenges in diagnosis and clinical management, representing a substantial burden for the public health system. Therefore, the present review narrates the neurological complications triggered by HIV and their diagnosis and treatment options. Moreover, coinfections that are known to cause neurological disorders in HIV infected individuals are highlighted.
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Affiliation(s)
- Sivaraman Balaji
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research-Headquarters, Ansari Nagar, New Delhi, 110029, India
| | - Rohan Chakraborty
- Department of Medical Elementology and Toxicology, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi 110062, India
| | - Sumit Aggarwal
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research-Headquarters, Ansari Nagar, New Delhi, 110029, India
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Zhou YH, Zhao H. Re: 'Prevalence of human immunodeficiency virus, syphilis, and hepatitis B and C virus infections in pregnant women: a systematic review and meta-analysis' by Wu et al. Clin Microbiol Infect 2024; 30:143-144. [PMID: 37805029 DOI: 10.1016/j.cmi.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 09/29/2023] [Accepted: 10/01/2023] [Indexed: 10/09/2023]
Affiliation(s)
- Yi-Hua Zhou
- Departments of Laboratory Medicine, Infectious Diseases, and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Hong Zhao
- Department of Infectious Diseases, Second Hospital of Nanjing, Southeast University, Nanjing, Jiangsu, China.
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Abbasi F, Almukhtar M, Fazlollahpour-Naghibi A, Alizadeh F, Behzad Moghadam K, Jafari Tadi M, Ghadimi S, Bagheri K, Babaei H, Bijani MH, Rouholamin S, Razavi M, Rezaeinejad M, Chemaitelly H, Sepidarkish M, Farid-Mojtahedi M, Rostami A. Hepatitis C infection seroprevalence in pregnant women worldwide: a systematic review and meta-analysis. EClinicalMedicine 2023; 66:102327. [PMID: 38045801 PMCID: PMC10692665 DOI: 10.1016/j.eclinm.2023.102327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/26/2023] [Accepted: 11/06/2023] [Indexed: 12/05/2023] Open
Abstract
Background Monitoring progress towards the WHO global target to eliminate hepatitis C virus (HCV) infection by 2030, entails reliable prevalence estimates for HCV infection in different populations. Little is known about the global burden of HCV infection in pregnant women. Here, for the first time to our knowledge, we estimated the global and regional seroprevalence of HCV antibody (Ab) and determinants in pregnant women. Methods In this systematic review and meta-analysis study, we searched PubMed/MEDLINE, Web of Science, Embase, Scopus, and SciELO databases for peer-reviewed observational studies between January 1, 2000 and April 1, 2023, without language or geographical restrictions. Pooled global seroprevalence (and 95% confidence interval, CI) were estimated using random-effects meta-analysis and seroprevalences were categorised according to World Health Organization regions and subregions, publishing year, countries' income and human development index (HDI) levels. We used sensitivity analysis to assess the effect of four large sample size studies on pooled global prevalence through the "leave-one-out" method. We also investigated the association of potential risk factors with HCV seropositivity in pregnant women by subgroup and meta-regression analyses. The Protocol was registered in PROSPERO CRD42023423259. Findings We included 192 eligible studies (208 datasets), with data for 148,509,760 pregnant women from 53 countries. The global seroprevalence of HCV Ab in pregnant women was 1.80% (95% CI, 1.72-1.89%) and 3.29% (3.01-3.57%) in overall and sensitivity analyses, respectively. The seroprevalence was highest in the Eastern Mediterranean region (6.21%, 4.39-8.29%) and lowest in the Western Pacific region (0.75%, 0.38-1.22%). Subgroup analysis indicated that the seroprevalence of HCV Ab among pregnant women was significantly higher for those with opioid use disorder (51.94%, 95% CI: 37.32-66.39) and HIV infection (4.34%, 95% CI: 2.21-7.06%) than for the general population of pregnant women (1.08%, 95% CI: 1.02-1.15%), as confirmed by multivariable meta-regression (p < 0.001). A significant decreasing trend was observed with increasing human development index levels. Other important risk factors for HCV seropositivity included older age, lower educational levels, poly sexual activity, history of blood transfusion, hospitalization, surgery, abortion and sexual transmitted diseases, having scarification/tattoo or piercing, and testing hepatitis B positive. Interpretation This meta-analysis showed relatively high burden of exposure to HCV infection (2.2-5.3 million) in pregnant women globally. However, due to substantial heterogeneity between studies, our estimates might be different than the true seroprevalence. Our findings highlighted the need to expand HCV screening for women of reproductive age or during pregnancy, particularly in countries with high prevalence; as well as for more studies that assess safety of existing therapeutic drugs during pregnancy or potentially support development of drugs for pregnant women. Funding There was no funding source for this study.
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Affiliation(s)
- Farzaneh Abbasi
- Infectious Diseases and Tropical Medicine Research Centre, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | | | - Andarz Fazlollahpour-Naghibi
- Infectious Diseases and Tropical Medicine Research Centre, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Faezeh Alizadeh
- Department of Pharmaceutical Sciences, University of Illinois, Chicago, USA
| | | | - Mehrdad Jafari Tadi
- Department of Cell and Molecular Medicine, Rush University Medical Centre, Chicago, IL, 60607, USA
| | - Saleh Ghadimi
- Infectious Diseases and Tropical Medicine Research Centre, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Kimia Bagheri
- Infectious Diseases and Tropical Medicine Research Centre, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Hedye Babaei
- Infectious Diseases and Tropical Medicine Research Centre, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Hossein Bijani
- Infectious Diseases and Tropical Medicine Research Centre, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Safoura Rouholamin
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Razavi
- Department of Obstetrics and Gynecology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mahroo Rezaeinejad
- Department of Obstetrics and Gynecology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Cornell University, Qatar Foundation – Education City, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Mahdi Sepidarkish
- Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
| | - Maryam Farid-Mojtahedi
- Department of Obstetrics and Gynecology, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Rostami
- Infectious Diseases and Tropical Medicine Research Centre, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Osegueda A, Polo ML, Baquero L, Urioste A, Ghiglione Y, Paz S, Poblete G, Gonzalez Polo V, Turk G, Quiroga MF, Laufer N. Markers of Natural Killer Cell Exhaustion in HIV/HCV Coinfection and Their Dynamics After HCV Clearance Mediated by Direct-Acting Antivirals. Open Forum Infect Dis 2023; 10:ofad591. [PMID: 38107019 PMCID: PMC10723816 DOI: 10.1093/ofid/ofad591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 11/20/2023] [Indexed: 12/19/2023] Open
Abstract
Background Liver fibrosis is a leading cause of morbimortality in people with HIV/hepatitis C virus (HCV). Natural killer (NK) cells are linked with amelioration of liver fibrosis; however, NK cells from individuals coinfected with HIV/HCV with cirrhosis display impaired functionality and high PD-1 expression. Here, we aimed to study PD-1, TIGIT, and Tim3 as potential exhaustion markers in NK cells from persons coinfected with HIV/HCV with mild and advanced liver fibrosis. We also evaluated the role of PD-1 expression on NK cells after HCV clearance by direct-acting antivirals (DAAs). Methods Peripheral blood mononuclear cells were isolated from individuals coinfected with HIV/HCV (N = 54; METAVIR F0/F1, n = 27; F4, evaluated by transient elastography, n = 27). In 26 participants, samples were collected before, at the end of, and 12 months after successful DAA treatment. The frequency, immunophenotype (PD-1, TIGIT, and Tim3 expression), and degranulation capacity (CD107a assay) of NK cells were determined by flow cytometry. Results Unlike PD-1, Tim3 and TIGIT were comparably expressed between persons with mild and advanced fibrosis. Degranulation capacity was diminished in NK/TIGIT+ cells in both fibrosis stages, while NK/PD-1+ cells showed a lower CD107a expression in cirrhotic cases. Twelve months after DAA treatment, those with advanced fibrosis showed an improved NK cell frequency and reduced NK/PD-1+ cell frequency but no changes in CD107a expression. In individuals with mild fibrosis, neither PD-1 nor NK cell frequency was modified, although the percentage of NK/CD107a+ cells was improved at 12 months posttreatment. Conclusions Although DAA improved exhaustion and frequency of NK cells in cirrhotic cases, functionality was reverted only in mild liver fibrosis, remarking the importance of an early DAA treatment.
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Affiliation(s)
- Ariel Osegueda
- CONICET-Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Buenos Aires, Argentina
- Universidad de Buenos Aires, Facultad de Medicina. Buenos Aires, Argentina
| | - Maria Laura Polo
- CONICET-Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Buenos Aires, Argentina
- Universidad de Buenos Aires, Facultad de Medicina. Buenos Aires, Argentina
| | - Lucia Baquero
- CONICET-Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Buenos Aires, Argentina
- Universidad de Buenos Aires, Facultad de Medicina, Departamento de Microbiología, Parasitología e Inmunología, Buenos Aires, Argentina
| | - Alejandra Urioste
- CONICET-Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Buenos Aires, Argentina
- Universidad de Buenos Aires, Facultad de Medicina. Buenos Aires, Argentina
| | - Yanina Ghiglione
- CONICET-Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Buenos Aires, Argentina
- Universidad de Buenos Aires, Facultad de Medicina. Buenos Aires, Argentina
| | - Silvia Paz
- Hospital Francisco Javier Muñiz, Buenos Aires, Argentina
| | | | - Virginia Gonzalez Polo
- CONICET-Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Buenos Aires, Argentina
- Universidad de Buenos Aires, Facultad de Medicina. Buenos Aires, Argentina
| | - Gabriela Turk
- CONICET-Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Buenos Aires, Argentina
- Universidad de Buenos Aires, Facultad de Medicina, Departamento de Microbiología, Parasitología e Inmunología, Buenos Aires, Argentina
| | - Maria Florencia Quiroga
- CONICET-Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Buenos Aires, Argentina
- Universidad de Buenos Aires, Facultad de Medicina, Departamento de Microbiología, Parasitología e Inmunología, Buenos Aires, Argentina
| | - Natalia Laufer
- CONICET-Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Buenos Aires, Argentina
- Universidad de Buenos Aires, Facultad de Medicina, Departamento de Microbiología, Parasitología e Inmunología, Buenos Aires, Argentina
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Ikeuchi K, Saito M, Adachi E, Koga M, Okushin K, Tsutsumi T, Yotsuyanagi H. Injection drug use and sexually transmitted infections among men who have sex with men: A retrospective cohort study at an HIV/AIDS referral hospital in Tokyo, 2013-2022. Epidemiol Infect 2023; 151:e195. [PMID: 37965724 PMCID: PMC10728981 DOI: 10.1017/s0950268823001772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 09/13/2023] [Accepted: 10/27/2023] [Indexed: 11/16/2023] Open
Abstract
Men who have sex with men (MSM) who use injection drugs (MSM-IDU) are at high risk of sexually transmitted infections (STIs), but the long-term incidence is unclear. We conducted a single-centre retrospective cohort study using the clinical records of non-haemophilia men with human immunodeficiency virus (HIV) who visited the Institute of Medical Science, the University of Tokyo (IMSUT) Hospital, located in Tokyo, Japan, from 2013 to 2022. We analysed 575 patients including 62 heterosexual males and 513 MSM patients, of whom 6.8% (35/513) were injection drug use (IDU). Compared to non-IDU MSM, MSM-IDU had a higher incidence of hepatitis C virus (HCV) (44.8 vs 3.5 /1,000 person-years (PY); incidence rate ratio (IRR) [95% confidence interval (95% CI)], 12.8 [5.5-29.3], p < 0.001) and syphilis (113.8 vs 53.3 /1,000 PY; IRR, 2.1 [1.4-3.1], p < 0.001). The incidence of other symptomatic STIs (amoebiasis, chlamydia, and gonorrhoea infections) was <4/1,000 PY. In multivariable Poisson regression analysis, HCV incidence was associated with MSM (IRR, 1.8 × 106 [9.9 × 105-3.4 × 106], p < 0.001), IDU (IRR, 10.1 [4.0-25.6], p < 0.001), and syphilis infection during the study period (IRR, 25.0 [1.2-518.3]/time/year, p < 0.001). Among men with HIV, the prevalence of IDU in MSM and the long-term incidence of STIs in MSM-IDU were high. IDU and sexual contact are important modes of transmission of HCV among HIV-infected MSM in Tokyo.
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Affiliation(s)
- Kazuhiko Ikeuchi
- Department of Infectious Diseases and Applied Immunology, IMSUT Hospital of The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, Japan
- Division of Infectious Diseases, Advanced Clinical Research Center, Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, Japan
| | - Makoto Saito
- Division of Infectious Diseases, Advanced Clinical Research Center, Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, Japan
| | - Eisuke Adachi
- Department of Infectious Diseases and Applied Immunology, IMSUT Hospital of The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, Japan
| | - Michiko Koga
- Division of Infectious Diseases, Advanced Clinical Research Center, Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, Japan
| | - Kazuya Okushin
- Department of Infection Control and Prevention, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Takeya Tsutsumi
- Department of Infectious Diseases and Applied Immunology, IMSUT Hospital of The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, Japan
- Department of Infection Control and Prevention, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Hiroshi Yotsuyanagi
- Department of Infectious Diseases and Applied Immunology, IMSUT Hospital of The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, Japan
- Division of Infectious Diseases, Advanced Clinical Research Center, Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, Japan
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Shengir M, Fillebeen C, Wagner J, Ramanakumar AV, Kaouache M, Klein MB, Pantopoulos K, Sebastiani G. Increased Serum Fibroblast Growth Factor 23 Predicts Mortality in People With HIV/HCV Coinfection. J Acquir Immune Defic Syndr 2023; 94:273-279. [PMID: 37368933 DOI: 10.1097/qai.0000000000003245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND People with HIV and hepatitis C virus (HCV) coinfection experience excess mortality because of multiple causes. Identification of biomarkers associated with mortality beyond that attributable to liver fibrosis may be relevant for prognostication. Fibroblast growth factor 23 (FGF23), a phosphotropic hormone, predicts adverse outcomes in several chronic conditions. We aimed to investigate whether elevated FGF23 predicts all-cause mortality in patients with HIV/HCV coinfection. METHODS We included patients with HIV/HCV coinfection from the Canadian Coinfection Cohort with available serum FGF23, fibrosis biomarker fibrosis-4 (FIB-4), and at least 1-year follow-up. Elevated FGF23 and advanced liver fibrosis were defined as FGF23 > 241 reference unit/mL and FIB-4 > 3.25, respectively. All-cause mortality was analyzed using survival analysis. The effect of advanced liver fibrosis as a mediator on mortality was estimated by mediation analysis. RESULTS Three hundred twenty-one patients were included (24% with elevated FGF23, 19% with advanced liver fibrosis). During a mean follow-up period of 8.4 years, 34% of the cohort died. The incidence rate of all-cause mortality was higher in patients with elevated FGF23 (66.1 per 1000 person-years, 95% confidence interval 45.8 to 92.3) relative to patients without elevated FGF23 (37.5 per 1000 person-years, 95% confidence interval 29.6 to 46.9). After adjusting for potential confounders, elevated FGF23 was associated with significant direct and indirect effects (mediated through advanced liver fibrosis) on all-cause mortality, with 57% of deaths not mediated through advanced fibrosis. CONCLUSIONS In patients with HIV/HCV coinfection, FGF23 may be used as prognostic biomarker for risk stratification accounting also for death causes other than those attributable to liver fibrosis.
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Affiliation(s)
- Mohamed Shengir
- Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
| | - Carine Fillebeen
- Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada
| | - John Wagner
- Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada
| | | | - Mohammed Kaouache
- Research Institute, McGill University Health Centre, Montreal, Quebec, Canada; and
| | - Marina B Klein
- Chronic Viral Illness Services, McGill University Health Center, Montreal, Quebec, Canada
| | - Kostas Pantopoulos
- Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada
| | - Giada Sebastiani
- Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
- Chronic Viral Illness Services, McGill University Health Center, Montreal, Quebec, Canada
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Abstract
Hepatitis delta virus (HDV) only infects patients with hepatitis B virus (HBV) due to its reliance on HBV surface proteins to form its envelope. With shared routes of transmission, HDV coinfection is estimated to occur in 15% of patients with HIV and HBV. However, HDV is often underdiagnosed and may be missed particularly in people living with HIV (PLWH) who are already on antiretroviral therapy with anti-HBV activity and coincidental HBV suppression. At the same time, HDV causes the most severe form of chronic viral hepatitis and leads to faster progression of liver disease and hepatocellular carcinoma. Thus, increased recognition and effective treatment are paramount, and as novel treatment options approach global markets, the study of their efficacy in PLWH should be pursued.
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Affiliation(s)
- Debra W Yen
- Division of Digestive Diseases, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Vicente Soriano
- Health Sciences School & Medical Center, Universidad Internacional La Rioja (UNIR), Madrid, Spain
| | - Pablo Barreiro
- Public Health Regional Laboratory, Hospital Isabel Zendal, Universidad Rey Juan Carlos, Madrid, Spain
| | - Kenneth E Sherman
- Division of Digestive Diseases, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.
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Hage K, van de Kerkhof M, Boyd A, Carson JM, Newsum AM, Matser A, van der Valk M, Brinkman K, Arends JE, Lauw FN, Rijnders BJA, van Eeden A, Martinello M, Matthews GV, Schinkel J, Prins M. Screening for Hepatitis C Virus Reinfection Using a Behaviour-Based Risk Score among Men Who Have Sex with Men with HIV: Results from a Case-Control Diagnostic Validation Study. Pathogens 2023; 12:1248. [PMID: 37887764 PMCID: PMC10610046 DOI: 10.3390/pathogens12101248] [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] [Received: 08/11/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 10/28/2023] Open
Abstract
We assessed the predictive capacity of the HCV-MOSAIC risk score, originally developed for primary early HCV infection, as a screening tool for HCV reinfection in 103 men who have sex with men (MSM) with HIV using data from the MOSAIC cohort, including MSM with HIV/HCV-coinfection who became reinfected (cases, n = 27) or not (controls, n = 76) during follow-up. The overall predictive capacity of the score was assessed using the area under the receiver operating characteristic (AUROC) curve. The effects of covariates on the receiver operating characteristic (ROC) curve were assessed using parametric ROC regression. The score cut-off validated for primary early infection (≥2.0) was used, from which the sensitivity and specificity were calculated. The AUROC was 0.74 (95% confidence interval (CI) = 0.63-0.84). Group sex significantly increased the predictive capacity. Using the validated cut-off, sensitivity was 70.4% (95%CI = 49.8-86.2%) and specificity was 59.2% (95%CI: 47.3-70.4%). External validation from a cohort of 25 cases and 111 controls, all MSM with HIV, resulted in a sensitivity of 44.0% (95%CI = 24.4-65.1) and specificity of 71.2% (95%CI = 61.8-79.4). The HCV-MOSAIC risk score may be useful for identifying individuals at risk of HCV reinfection. In sexual health or HIV-care settings, this score could help guide HCV-RNA testing in MSM with a prior HCV infection.
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Affiliation(s)
- Kris Hage
- Department of Infectious Diseases, Public Health Service of Amsterdam, 1018 WT Amsterdam, The Netherlands
- Infectious Diseases, Amsterdam UMC Location, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
- Infectious Diseases, Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands
| | - Marita van de Kerkhof
- Department of Infectious Diseases, Public Health Service of Amsterdam, 1018 WT Amsterdam, The Netherlands
- Stichting SBOH, 3528 BB Utrecht, The Netherlands
| | - Anders Boyd
- Department of Infectious Diseases, Public Health Service of Amsterdam, 1018 WT Amsterdam, The Netherlands
- Stichting HIV Monitoring (SHM), 1105 BD Amsterdam, The Netherlands
| | - Joanne M. Carson
- The Kirby Institute, University of New South Wales, Sydney 2052, Australia
| | - Astrid M. Newsum
- Department of Infectious Diseases, Public Health Service of Amsterdam, 1018 WT Amsterdam, The Netherlands
- Infectious Diseases, Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands
| | - Amy Matser
- Department of Infectious Diseases, Public Health Service of Amsterdam, 1018 WT Amsterdam, The Netherlands
- Infectious Diseases, Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands
| | - Marc van der Valk
- Infectious Diseases, Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands
- Stichting HIV Monitoring (SHM), 1105 BD Amsterdam, The Netherlands
| | - Kees Brinkman
- Department of Internal Medicine, Onze Lieve Vrouwe Gasthuis (OLVG), 1091 AC Amsterdam, The Netherlands
| | - Joop E. Arends
- Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht (UMCU), 3584 CX Utrecht, The Netherlands
- Department of Health, Medicine and Life Sciences, Maastricht University, 6211 LK Maastricht, The Netherlands
| | - Fanny N. Lauw
- Department of Internal Medicine, Medical Centre Jan van Goyen, 1075 HN Amsterdam, The Netherlands
| | - Bart J. A. Rijnders
- Department of Internal Medicine and Infectious Diseases, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Arne van Eeden
- Department of Internal Medicine, DC Klinieken Oud Zuid, 1075 BG Amsterdam, The Netherlands
| | | | - Gail V. Matthews
- The Kirby Institute, University of New South Wales, Sydney 2052, Australia
| | - Janke Schinkel
- Medical Microbiology and Infection Prevention, Amsterdam UMC Location, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Maria Prins
- Department of Infectious Diseases, Public Health Service of Amsterdam, 1018 WT Amsterdam, The Netherlands
- Infectious Diseases, Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands
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Chen P, Simonetto DA, Paul S, Patel A. Health disparities experienced by sexual and gender minority individuals living with or at risk of chronic liver disease. Clin Liver Dis (Hoboken) 2023; 22:152-156. [PMID: 37908866 PMCID: PMC10615390 DOI: 10.1097/cld.0000000000000073] [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: 11/15/2022] [Accepted: 04/28/2023] [Indexed: 11/02/2023] Open
Affiliation(s)
- Phillip Chen
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Douglas A. Simonetto
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Sonali Paul
- Department of Gastroenterology, Hepatology, and Nutrition, Center for Liver Diseases, The University of Chicago Medicine, Chicago, Illinois, USA
| | - Arpan Patel
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Department of Gastroenterology, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
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d'Arminio Monforte A, Tavelli A, Rossotti R, Gagliardini R, Saracino A, Lo Caputo S, Sala M, Quiros-Roldan E, Mussini C, Girardi E, Cozzi-Lepri A, Antinori A, Puoti M. Is HCV elimination among persons living with HIV feasible? Data from the NoCo study in the setting of the ICONA cohort. Liver Int 2023; 43:2130-2141. [PMID: 37649460 DOI: 10.1111/liv.15700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/21/2023] [Accepted: 08/07/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND AND AIMS Whether the HCV test-and-treat strategy impacted on the rate of new HCV infections among PLWH in Italy is unknown. METHODS Prospective study of PLWH in the ICONA network. At baseline, PLWH were tested for HCV-Ab; HCV-RNA (if HCV-Ab positive) and, if positive, treated with DAA. SVR12 indicated eradication. Seroconversions and re-infections were evaluated yearly in HCV-Ab neg and HCV-RNA neg at first screening. We estimated the following: HCV seroconversions, incidence of HCV reinfections, and access to DAA and SVR12 rates tighter with factors associated with each outcome. Data were analysed by Cox regression, Poisson regression and logistic regression models. RESULTS Sixteen thousand seven hundred and forty-three PLWH were included; 27.3% HCV-Ab positive; of these, 39.3% HCV-RNA positive. HCV seroconversion incidence: .48/100 PYFU (95% CI: .36-.65); re-infections incidence: 1.40/100 PYFU (95% CI: .91-2.04). The risk factor for HCV re-infection was young age: aIRR 1.85, 95% CI: 1.17-2.95) per 10 years younger. 86.4% of HCV viremic in follow-up started DAA. PWID vs. heterosexuals (aHR .75, 95% CI .62-.90), HIV-RNA >50 copies/mL (aHR .70, 95% CI .56-.87), HCV genotype other than G1, G2, G3, G4 or with multiple/missing HCV genotype and post-COVID-19 calendar periods were associated with lower DAA access. 922/965 (95.5%) PLWH achieved SVR12. We estimated 72% reduction of chance to achieve SVR12 in PLWH with a CD4 count <200/mm3 (vs. CD4 ≥200/mm3 aOR .18, 95% CI: .07-.46). 95.5% of DAA-treated individuals eradicated HCV, but they represent only 53.2% of HCV viremic PLWH and 66.4% of those in follow-up. HCV-RNA positivity by year decreased from 41.7% in 2017 to 11.7% in 2022. CONCLUSIONS The screening-and-treat campaign implemented in Italy, even if only partially effective, resulted in a dramatic drop in HCV circulation in our cohort.
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Affiliation(s)
| | | | - Roberto Rossotti
- Infectious Diseases Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Roberta Gagliardini
- Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Annalisa Saracino
- Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari, University Hospital Policlinico, Bari, Italy
| | - Sergio Lo Caputo
- Department of Clinical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Matteo Sala
- Unit of Infectious and Tropical Diseases, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Eugenia Quiros-Roldan
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Cristina Mussini
- AOU of Modena, Clinic of Infectious Diseases, University of Modena and Reggio Emilia, Modena, Italy
| | - Enrico Girardi
- Scientific Direction, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Alessandro Cozzi-Lepri
- Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, UCL, London, UK
| | - Andrea Antinori
- Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Massimo Puoti
- Infectious Diseases Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- University of Milano-Bicocca, Milan, Italy
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