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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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2
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Munari SC, Traeger MW, Menon V, Latham NH, Manoharan L, Luhmann N, Baggaley R, MacDonald V, Verster A, Siegfried N, Conway B, Klein M, Bruneau J, Stoové MA, Hellard ME, Doyle JS. Determining reinfection rates by hepatitis C testing interval among key populations: A systematic review and meta-analysis. Liver Int 2023; 43:2625-2644. [PMID: 37817387 DOI: 10.1111/liv.15705] [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: 11/15/2022] [Revised: 08/04/2023] [Accepted: 08/08/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND & AIMS Detecting hepatitis C virus (HCV) reinfection among key populations helps prevent ongoing transmission. This systematic review aims to determine the association between different testing intervals during post-SVR follow-up on the detection of HCV reinfection among highest risk populations. METHODS We searched electronic databases between January 2014 and February 2023 for studies that tested individuals at risk for HCV reinfection at discrete testing intervals and reported HCV reinfection incidence among key populations. Pooled estimates of reinfection incidence were calculated by population and testing frequency using random-effects meta-analysis. RESULTS Forty-one single-armed observational studies (9453 individuals) were included. Thirty-eight studies (8931 individuals) reported HCV reinfection incidence rate and were included in meta-analyses. The overall pooled estimate of HCV reinfection incidence rate was 4.13 per 100 per person-years (py) (95% confidence interval [CI]: 3.45-4.81). The pooled incidence estimate among people who inject drugs (PWID) was 2.84 per 100 py (95% CI: 2.19-3.50), among men who have sex with men (MSM) 7.37 per 100 py (95% CI: 5.09-9.65) and among people in custodial settings 7.23 per 100 py (95% CI: 2.13-16.59). The pooled incidence estimate for studies reporting a testing interval of ≤6 months (4.26 per 100 py; 95% CI: 2.86-5.65) was higher than studies reporting testing intervals >6 months (5.19 per 100 py; 95% CI: 3.92-6.46). CONCLUSIONS HCV reinfection incidence was highest in studies of MSM and did not appear to change with retesting interval. Shorter testing intervals are likely to identify more reinfections, help prevent onward transmission where treatment is available and enable progress towards global HCV elimination, but additional comparative studies are required.
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Affiliation(s)
| | - Michael W Traeger
- Disease Elimination Program, Burnet Institute, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Vinay Menon
- Disease Elimination Program, Burnet Institute, Melbourne, Australia
| | - Ned H Latham
- Disease Elimination Program, Burnet Institute, Melbourne, Australia
| | | | - Niklas Luhmann
- World Health Organization, Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, Geneva, Switzerland
| | - Rachel Baggaley
- World Health Organization, Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, Geneva, Switzerland
| | - Virginia MacDonald
- World Health Organization, Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, Geneva, Switzerland
| | - Annette Verster
- World Health Organization, Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, Geneva, Switzerland
| | - Nandi Siegfried
- Independent Clinical Epidemiologist, Cape Town, South Africa
| | - Brian Conway
- Vancouver Infectious Diseases Centre & Simon Fraser University Vancouver, Canada
| | - Marina Klein
- Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Julie Bruneau
- Department of Family and Emergency Medicine, Université de Montréal, Montreal, Canada
| | - Mark A Stoové
- Disease Elimination Program, Burnet Institute, Melbourne, Australia
| | - Margaret E Hellard
- Disease Elimination Program, Burnet Institute, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Department of Infectious Diseases, The Alfred Hospital and Monash University, Melbourne, Australia
| | - Joseph S Doyle
- Disease Elimination Program, Burnet Institute, Melbourne, Australia
- Department of Infectious Diseases, The Alfred Hospital and Monash University, Melbourne, Australia
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3
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Gonzalez-Serna A, Corma-Gomez A, Tellez F, Corona-Mata D, Rios-Villegas MJ, Merino D, Galera C, Collado-Romacho AR, De Los Santos I, Cucurull J, Santos M, García-Martín S, Rivero A, Real LM, Macias J. Response to glecaprevir/pibrentasvir in HIV/HCV-coinfected patients in clinical practice. J Antimicrob Chemother 2023; 78:2591-2596. [PMID: 37671831 PMCID: PMC10775154 DOI: 10.1093/jac/dkad278] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/16/2023] [Indexed: 09/07/2023] Open
Abstract
OBJECTIVES HIV infection has been associated with lower rates of sustained viral response (SVR) with direct-acting antivirals (DAAs). There are few data on glecaprevir/pibrentasvir (G/P) in HIV/HCV coinfection outside clinical trials. METHODS The HEPAVIR-DAA cohort, which recruits HIV/HCV-coinfected patients (NCT02057003) and the GEHEP-MONO cohort (NCT02333292), including HCV-monoinfected individuals, are two concurrent ongoing multicentre cohorts of patients receiving anti-HCV treatment. Patients starting G/P included in those cohorts were analysed. Overall SVR (ITT), discontinuations due to adverse effects, and dropouts were evaluated and compared between both cohorts. RESULTS Of the 644 patients who started G/P with evaluable SVR, 132 were HIV/HCV coinfected. Overall SVR rates were 487/512 (95.1%) in HCV-monoinfected patients versus 126/132 (95.5%) in HIV/HCV-coinfected patients (P = 1.000). One patient (0.8%) relapsed, and another (0.8%) discontinued treatment due to side effects. SVR to 8 or 12 weeks of treatment with G/P was similar in HIV/HCV-coinfected versus HCV-monoinfected patients. The main reason for not reaching SVR among HIV/HCV-coinfected patients was premature dropout linked to active drug use. CONCLUSIONS G/P in HIV/HCV coinfection was highly effective and tolerable in clinical practice. SVR to 8 or 12 weeks of treatment with G/P was similar in HIV/HCV-coinfected compared with HCV-monoinfected patients but active drug use is still a barrier to reach HCV microelimination.
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Affiliation(s)
- Alejandro Gonzalez-Serna
- Infectious Diseases and Microbiology Unit, Hospital Universitario de Valme, Avda Bellavista s/n, 41014 Seville, Spain
- Departamento de Fisiología, Facultad de Farmacia, Universidad de Sevilla, Sevilla, Spain
- Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC, GEHEP-001, Sevilla, Spain
| | - Anaïs Corma-Gomez
- Infectious Diseases and Microbiology Unit, Hospital Universitario de Valme, Avda Bellavista s/n, 41014 Seville, Spain
- Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC, GEHEP-001, Sevilla, Spain
| | - Francisco Tellez
- Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC, GEHEP-001, Sevilla, Spain
- UGC Enfermedades Infecciosas, Departamento de Medicina, Universidad de Cádiz, Hospital Universitario de Puerto Real, Cádiz, Spain
| | - Diana Corona-Mata
- Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC, GEHEP-001, Sevilla, Spain
- Infectious Diseases Unit. Maimonides Institute of Biomedical Research of Córdoba (Instituto Maimónides de Investigación Biomédica de Córdoba IMIBIC), Reina Sofía University Hospital of Córdoba, University of Córdoba, Córdoba, Spain
| | - María Jose Rios-Villegas
- Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC, GEHEP-001, Sevilla, Spain
- Hospital Universitario Virgen Macarena, Unidad de Enfermedades Infecciosas, Sevilla, Spain
| | - Dolores Merino
- Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC, GEHEP-001, Sevilla, Spain
- Hospital Juan Ramón Jiménez, Unidad de Enfermedades Infecciosas, Huelva, Spain
| | - Carlos Galera
- Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC, GEHEP-001, Sevilla, Spain
- Hospital Universitario Virgen de la Arrixaca, Unidad de Medicina Interna, Murcia, Spain
| | - Antonio Ramon Collado-Romacho
- Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC, GEHEP-001, Sevilla, Spain
- Unidad de Enfermedades Infecciosas, Hospital Universitario Torrecárdenas, Almería, Spain
| | - Ignacio De Los Santos
- Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC, GEHEP-001, Sevilla, Spain
- CIBERINFEC, Hospital Universitario de La Princesa, Madrid, Spain
| | - Josep Cucurull
- Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC, GEHEP-001, Sevilla, Spain
- Medicina Interna, Fundació Salut Empordà, Figueres, Spain
| | - Marta Santos
- Infectious Diseases and Microbiology Unit, Hospital Universitario de Valme, Avda Bellavista s/n, 41014 Seville, Spain
- Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC, GEHEP-001, Sevilla, Spain
| | - Sofía García-Martín
- Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC, GEHEP-001, Sevilla, Spain
- UGC Microbiología, Hospital Universitario de Puerto Real, Cádiz, Spain
| | - Antonio Rivero
- Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC, GEHEP-001, Sevilla, Spain
- Infectious Diseases Unit. Maimonides Institute of Biomedical Research of Córdoba (Instituto Maimónides de Investigación Biomédica de Córdoba IMIBIC), Reina Sofía University Hospital of Córdoba, University of Córdoba, Córdoba, Spain
| | - Luis Miguel Real
- Infectious Diseases and Microbiology Unit, Hospital Universitario de Valme, Avda Bellavista s/n, 41014 Seville, Spain
- Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC, GEHEP-001, Sevilla, Spain
- Departamento de Especialidades Quirúrgicas, Bioquímica e Inmunología, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
| | - Juan Macias
- Infectious Diseases and Microbiology Unit, Hospital Universitario de Valme, Avda Bellavista s/n, 41014 Seville, Spain
- Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC, GEHEP-001, Sevilla, Spain
- Departamento de Medicina, Universidad de Sevilla, Sevilla, Spain
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4
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Santos M, Corma-Gómez A, Fernandez-Fuertes M, González-Serna A, Rincón P, Real LM, Pineda JA, Macías J. Burden of significant liver damage in people living with HIV after microelimination of the hepatitis C virus. J Infect 2023; 86:41-46. [PMID: 36410455 DOI: 10.1016/j.jinf.2022.11.004] [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: 03/17/2022] [Revised: 11/06/2022] [Accepted: 11/08/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Once HIV/HCV-coinfection microelimination has been virtually achieved in some countries, there is no information about the burden of liver disease among people living with HIV (PLWH). The aim of this study was to define the current prevalence and causes of significant liver damage (SLD) in PLWH. METHODS Cross-sectional study including 619 PLWH. SLD was defined as liver stiffness (LS) ≥ 7.2 kPa measured by transient elastography. Nonviral liver damage (NVLD) was considered if there was no evidence injury due to chronic hepatitis C virus (HCV) infection, active hepatitis B (HBV) or E virus infections. RESULTS One hundred and twelve of 619 (18.2%) PLWH showed SLD, including 34/112 (5.5%) with LS ≥14 kPa. 72/112 (64.3%) had cured HCV infection, 4/112 (3.6%) active HBV infection, and 2/112 HBV/prior HCV coinfection. Thus, 40 (35.7%) showed NVLD. Metabolic associated steatohepatitis (MASH) was present in 29/40 (72.5%) of patients with NVLD, alcoholic liver damage in 2/40 (2.5%) and mixed steatohepatitis in 5/40 (12.5%). CONCLUSIONS After HIV/HCV microelimination the burden of liver damage is high among PLWH. Persistent injury after HCV is a very frequent cause of SLD. However, NVLD, mainly due to MASH, is also a common condition in this population.
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Affiliation(s)
- M Santos
- Unidad de Enfermedades Infecciosas y Microbiología. Hospital Universitario Virgen de Valme. Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBiS), Spain; CIBERINFEC. Spain
| | - A Corma-Gómez
- Unidad de Enfermedades Infecciosas y Microbiología. Hospital Universitario Virgen de Valme. Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBiS), Spain; CIBERINFEC. Spain
| | - M Fernandez-Fuertes
- Unidad de Enfermedades Infecciosas y Microbiología. Hospital Universitario Virgen de Valme. Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBiS), Spain; CIBERINFEC. Spain
| | - A González-Serna
- Unidad de Enfermedades Infecciosas y Microbiología. Hospital Universitario Virgen de Valme. Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBiS), Spain; CIBERINFEC. Spain; Department of Physiology, University of Sevilla. Sevilla, Spain
| | - P Rincón
- Unidad de Enfermedades Infecciosas y Microbiología. Hospital Universitario Virgen de Valme. Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBiS), Spain; CIBERINFEC. Spain
| | - L M Real
- Unidad de Enfermedades Infecciosas y Microbiología. Hospital Universitario Virgen de Valme. Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBiS), Spain; CIBERINFEC. Spain; Department of Surgical Specialties, Biochemistry and Immunology. University of Málaga, Málaga, Spain
| | - J A Pineda
- Unidad de Enfermedades Infecciosas y Microbiología. Hospital Universitario Virgen de Valme. Sevilla, Spain; CIBERINFEC. Spain; Department of Medicine. University of Sevilla. Sevilla, Spain.
| | - J Macías
- Unidad de Enfermedades Infecciosas y Microbiología. Hospital Universitario Virgen de Valme. Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBiS), Spain; CIBERINFEC. Spain; Department of Medicine. University of Sevilla. Sevilla, Spain
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5
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Factor SH, Fierer DS. Can treatment, without prevention, eliminate hepatitis C among men who have sex with men? J Viral Hepat 2022; 29:1048-1049. [PMID: 35748744 DOI: 10.1111/jvh.13726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 05/31/2022] [Indexed: 12/09/2022]
Affiliation(s)
- Stephanie H Factor
- Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Daniel S Fierer
- Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Li C, Zhou Y, Wang Y, Liu S, Wang W, Lu X, Sun C, Liu P, Wen Y. The Screening of Hepatitis B and Hepatitis C Virus Infection among HIV-Infected Inpatients and Evaluation of Correlated Characteristics in a General Hospital in Shenyang, Liaoning, China. J Clin Med 2022; 11:jcm11226620. [PMID: 36431096 PMCID: PMC9692379 DOI: 10.3390/jcm11226620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/30/2022] [Accepted: 11/05/2022] [Indexed: 11/11/2022] Open
Abstract
Background: In this study, we surveyed the prevalence of hepatitis B virus (HBV) surface antigen (HBsAg) and hepatitis C virus (HCV) antibody (anti-HCV) among inpatients with human immunodeficiency virus (HIV) infection and analyzed the correlated factors. Methods: We conducted a retrospective data collection of the HIV-infected inpatients in our hospital from January 2010 to December 2020. We utilized multivariate logistic regression to identify the correlated factors. Results: The proportion of patients screened for HBsAg was 81.8%, which increased from 66.7% in 2010 to 85.7% in 2020. The proportion of patients with anti-HCV screening was 73.9%, which increased from 58.3% in 2010 to 86.7% in 2020. The prevalence of HBsAg positivity was 10.9%, which decreased from 15.0% in the period of 2010−2015 to 9.0% during 2016−2020. Positive anti-HCV was identified in 4.1% of cases. Compared to 4.8% in the period of 2010−2015, there was a similar prevalence of anti-HCV at 3.1% during 2016−2020. Among the HBsAg-positive cases, HBV deoxyribonucleic acid was screened in 70.8% of cases. Among the anti-HCV positive cases, HCV ribonucleic acid (RNA) was screened in 90% of cases. Albumin < 30 g/L, thrombocytopenia and aspartate aminotransferase (AST) > 40 U/L were associated with HBsAg positivity. AST > 40 U/L and higher CD4-positive T lymphocyte counts were associated with HIV/HCV coinfection. Conclusions: The routine screening for both HBV and HCV among HIV-positive inpatients has been greatly improved in the past decade. However, screening for the complete HBV serological markers in HIV-positive inpatients and HCV genotyping among HCV RNA-positive cases leaves much to be desired. A concerted effort should be made to improve HBV vaccine compliance in the HIV-positive population and provide direct-acting antiviral therapies to HCV RNA-positive patients.
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7
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Tsai HC, Chen IT, Chang HM, Lee SSJ, Chen YS. Trend of HIV Transmitted Drug Resistance After the Introduction of Single-Tablet Regimens in Southern Taiwan. Infect Drug Resist 2022; 15:5495-5507. [PMID: 36158235 PMCID: PMC9507459 DOI: 10.2147/idr.s382568] [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: 07/15/2022] [Accepted: 09/07/2022] [Indexed: 11/23/2022] Open
Abstract
Background The prevalence of transmitted drug resistance (TDR) after the universal implementation of STRs is unknown in Taiwan. Objective This study aimed to investigate the prevalence of TDR in patients with HIV-1 infection, clarify the risk factors for pol resistance, and compare differences in HIV drug resistance before and after the implementation of STRs in Taiwan. Methods Adult patients infected with HIV-1 were enrolled in this study from 2013 to 2021. Mutations associated with drug resistance were identified using the 2019 International Antiviral Society-USA list of drug resistant mutations in HIV, and drug susceptibility was assessed according to the Stanford HIV Drug Resistance Database edition 9. A logistic regression model was used to analyze the risk factors for pol resistance, and the differences in the prevalence of drug resistance from 2013-2016 to 2017-2021 were compared using the Mann-Whitney U-test. General linear regression was used to analyze temporal changes in the annual proportion of TDR overall and by type of antiretroviral drugs. Results A total of 369 patients were included. The prevalence rate of pol resistance was 9.8% (36/369). The resistance rates to nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), and integrase strand transfer inhibitors (INSTIs) were 3.3%, 6.9%, 0% and 1.8%, respectively. The patients with hepatitis C infection were more likely to have pol resistance (aHR 5.767, CI 1.232-26.991, p=0.026). The prevalence rate of pol resistance did not decrease after the implementation of STRs as first-line therapy in 2017 (11.2% vs 8.7%, aHR 1.329, CI 0.667-2.645, p=0.480), and no significant temporal changes were shown in the annual proportion of TDR overall or by type of antiretroviral drug. Conclusion Our findings showed a stable prevalence rate of transmitted drug resistance despite the implementation of STRs as the first-line therapy in June 2016.
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Affiliation(s)
- Hung-Chin Tsai
- Division of Infectious Diseases, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Parasitology, Kaohsiung Medical University, Kaohsiung, Taiwan.,Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan.,Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
| | - I-Tzu Chen
- Division of Infectious Diseases, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Hui-Min Chang
- Department of Pharmacy, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Pharmacy and Graduate Institute of Pharmaceutical Technology, Tajen University, Pingtung, Taiwan
| | - Susan Shin-Jung Lee
- Division of Infectious Diseases, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yao-Shen Chen
- Division of Infectious Diseases, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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8
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Gonzalez-Serna A, Macias J, Corma-Gomez A, Tellez F, Cucurull J, Real LM, Granados R, Rivero-Juarez A, Hernandez-Quero J, Merino D, Palacios R, Rios MJ, Collado A, Pineda JA. High efficacy of glecaprevir/pibrentasvir for HCV-infected individuals with active drug use. J Infect 2022; 85:322-326. [PMID: 35700867 DOI: 10.1016/j.jinf.2022.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Real world data on glecaprevir/pibrentasvir (G/P) among active drug users are scarce. We evaluated the sustained virological response (SVR) rates of G/P among individuals with and without active drug use in routine clinical practice. METHODS Two ongoing prospective multicenter cohorts of individuals starting G/P were analyzed. Overall SVR intention-to-treat (ITT), discontinuations due to adverse effects and dropouts were evaluated. Results in patients with active, past and without active drug use were compared. RESULTS Overall, 644 individuals started G/P and have reached the date of SVR evaluation. Of them, 613 (95.2%) individuals achieved SVR. There were two (0.3%) relapses, one (0.2%) discontinuation due to side effects and 35 (5.4%) dropouts. SVR rates for patients with active drug use, past drug use and those who never used drugs were 85.4%(n/N = 70/82), 96.1%(n/N = 320/333) and 97.4%(n/N = 223/229) respectively (p < 0.001). After adjustment by sex, age, HCV genotype and opioid agonist therapy, active drug use was the only factor independently associated with SVR (ITT) [adjusted OR (95%confidence interval): 0.29(0.09-0.99),p = 0.048]. CONCLUSIONS Active drug use was independently associated with lower SVR rates to G/P, mainly due to voluntary dropout. G/P could be particularly beneficial in this scenario but specific strategies designed to increase the retention in care are needed.
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Affiliation(s)
- Alejandro Gonzalez-Serna
- Hospital Universitario de Valme, Seville, Spain; Departamento de Fisiología, Facultad de Farmacia, Universidad de Sevilla, Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Spain; Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC. GEHEP-001
| | - Juan Macias
- Hospital Universitario de Valme, Seville, Spain; Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Spain; Departamento de Medicina, Universidad de Sevilla, Sevilla, Spain; Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC. GEHEP-001.
| | - Anaïs Corma-Gomez
- Hospital Universitario de Valme, Seville, Spain; Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Spain; Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC. GEHEP-001
| | - Francisco Tellez
- Hospital Universitario de Puerto Real, Puerto Real, Spain; Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC. GEHEP-001
| | - Josep Cucurull
- Fundacio Salut Emporda (Fundació Privada), Figueres, Spain; Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC. GEHEP-001
| | - Luis M Real
- Hospital Universitario de Valme, Seville, Spain; Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Spain; Departamento de Especialidades Quirúrgicas, Bioquímica e Inmunología. Facultad de Medicina, Universidad de Málaga, Málaga, Spain; Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC. GEHEP-001
| | - Rafael Granados
- Hospital de Gran Canaria Dr. Negrín, Las Palmas de Gran Canarias, Spain; Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC. GEHEP-001
| | - Antonio Rivero-Juarez
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Spain; Instituto Maimonides de Investigación Biomedica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, Córdoba, Spain; Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC. GEHEP-001
| | - José Hernandez-Quero
- Hospital Universitario de San Cecilio de Granada, Granada, Spain; Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC. GEHEP-001
| | - Dolores Merino
- Hospital Juan Ramón Jiménez, Huelva, Spain; Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC. GEHEP-001
| | - Rosario Palacios
- Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC. GEHEP-001
| | - Maria José Rios
- Hospital Universitario Virgen Macarena, Sevilla, Spain; Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC. GEHEP-001
| | - Antonio Collado
- Hospital Universitario Torrecárdenas, Almería, Spain; Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC. GEHEP-001
| | - Juan A Pineda
- Hospital Universitario de Valme, Seville, Spain; Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Spain; Departamento de Medicina, Universidad de Sevilla, Sevilla, Spain; Grupo Estudio Hepatitis Víricas (GEHEP) de la SEIMC. GEHEP-001
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9
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Cuesta-Sancho S, Márquez-Coello M, Illanes-Álvarez F, Márquez-Ruiz D, Arizcorreta A, Galán-Sánchez F, Montiel N, Rodriguez-Iglesias M, Girón-González JA. Hepatitis C: Problems to extinction and residual hepatic and extrahepatic lesions after sustained virological response. World J Hepatol 2022; 14:62-79. [PMID: 35126840 PMCID: PMC8790402 DOI: 10.4254/wjh.v14.i1.62] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 08/02/2021] [Accepted: 12/10/2021] [Indexed: 02/06/2023] Open
Abstract
Loss of follow-up or reinfections hinder the expectations of hepatitis C eradication despite the existence of highly effective treatments. Moreover, the elimination of the infection does not imply the reversion of those chronic alterations derived from the previous infection by hepatitis C virus (HCV). This review analyzes the risk factors associated with loss to follow-up in diagnosis or treatment, and the possibility of reinfection. Likewise, it assesses the residual alterations induced by chronic HCV infection considering the liver alterations (inflammation, fibrosis, risk of decompensation, hepatocellular carcinoma, liver transplantation) and, on the other hand, the comorbidities and extrahepatic manifestations (cryoglobulinemia, non-Hodgkin lymphoma, peripheral insulin resistance, and lipid, bone and cognitive alterations). Peculiarities present in subjects coinfected with human immunodeficiency virus are analyzed in each section.
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Affiliation(s)
- Sara Cuesta-Sancho
- Medicina Interna, Hospital Universitario Puerta del Mar, Facultad de Medicina, Universidad de Cádiz, Instituto para la Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), Cádiz 11009, Spain
| | - Mercedes Márquez-Coello
- Medicina Interna, Hospital Universitario Puerta del Mar, Facultad de Medicina, Universidad de Cádiz, Instituto para la Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), Cádiz 11009, Spain
| | - Francisco Illanes-Álvarez
- Medicina Interna, Hospital Universitario Puerta del Mar, Facultad de Medicina, Universidad de Cádiz, Instituto para la Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), Cádiz 11009, Spain
| | - Denisse Márquez-Ruiz
- Medicina Interna, Hospital Universitario Puerta del Mar, Facultad de Medicina, Universidad de Cádiz, Instituto para la Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), Cádiz 11009, Spain
| | - Ana Arizcorreta
- Medicina Interna, Hospital Universitario Puerta del Mar, Facultad de Medicina, Universidad de Cádiz, Instituto para la Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), Cádiz 11009, Spain
| | - Fátima Galán-Sánchez
- Microbiología, Hospital Universitario Puerta del Mar, Facultad de Medicina, Universidad de Cádiz, Instituto para la Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), Cádiz 11009, Spain
| | - Natalia Montiel
- Microbiología, Hospital Universitario Puerta del Mar, Facultad de Medicina, Universidad de Cádiz, Instituto para la Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), Cádiz 11009, Spain
| | - Manuel Rodriguez-Iglesias
- Microbiología, Hospital Universitario Puerta del Mar, Facultad de Medicina, Universidad de Cádiz, Instituto para la Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), Cádiz 11009, Spain
| | - José-Antonio Girón-González
- Medicina Interna, Hospital Universitario Puerta del Mar, Facultad de Medicina, Universidad de Cádiz, Instituto para la Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), Cádiz 11009, Spain
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10
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Gómez-Ayerbe C, Palacios R, Ríos MJ, Téllez F, Sayago C, Martín-Aspas A, Camacho A, Muñoz L, Santos J. Acute hepatitis C virus infection and direct-acting antiviral drugs: Perfect combination to eliminate the epidemic? Int J STD AIDS 2021; 32:1257-1260. [PMID: 34293985 DOI: 10.1177/09564624211033756] [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: 11/15/2022]
Abstract
Early diagnosis and treatment of incident cases of hepatitis C virus (HCV) infection is fundamental to eliminate HCV in HIV-positive patients. From January 2016 to December 2019, we attended 40 episodes of acute HCV infection (AHC) in 35 subjects (9 reinfections) who were coinfected with HIV. The patients were treated with direct-acting antiviral agents (DAAs) in seven hospitals in Andalusia, Spain. All were men who have sex with men (MSM), mean age was 42.9 (±8.3) years and median time of HIV infection was 46.6 months (IQR: 20.4-67.2). All received antiretroviral therapy and had undetectable HIV viral load (except 2 with 65 and 68 copies/mL); median CD4 count was 632 cells/mm3 (IQR: 553-896). Over half (74.3%) also had another concomitant sexually transmitted infection, syphilis (48.6%) being the most common. AHC was asymptomatic in 32 cases (80%). Genotypeic distribution was G1a 65%, G4 32.5% and G1b 3%. Median time to DAA was 6 weeks (IQR: 4.3-18.3) and median baseline HCV RNA was 6.1 Log (IQR: 5.6-6.5). DAA regimens were SOF/LDV (19 episodes), SOF/VEL (14), ELB/GZV (5) and GLP/PIB (2). All presented sustained viral response and none discontinued due to adverse effects. In conclusion, early treatment with DAA in AHC patients proved effective and safe. It could be an excellent strategy to eliminate HCV infection in HIV-coinfected MSM.
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Affiliation(s)
- Cristina Gómez-Ayerbe
- Instituto de Investigación Biomédica de Málaga (IBIMA), 16867Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Rosario Palacios
- Instituto de Investigación Biomédica de Málaga (IBIMA), 16867Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Maria J Ríos
- 16582Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Francisco Téllez
- Departamento de Medicina, Universidad de Cádiz, 16875Hospital Universitario de Puerto Real, Puerto Real, Spain
| | - Carmen Sayago
- 16583Hospital Universitario Virgen de Valme, Sevilla, Spain
| | | | | | | | - Jesús Santos
- Instituto de Investigación Biomédica de Málaga (IBIMA), 16867Hospital Universitario Virgen de la Victoria, Málaga, Spain
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11
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Higuera-de la Tijera F, Servín-Caamaño A, Servín-Abad L. Progress and challenges in the comprehensive management of chronic viral hepatitis: Key ways to achieve the elimination. World J Gastroenterol 2021; 27:4004-4017. [PMID: 34326610 PMCID: PMC8311524 DOI: 10.3748/wjg.v27.i26.4004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/04/2021] [Accepted: 06/17/2021] [Indexed: 02/06/2023] Open
Abstract
Chronic viral hepatitis is a significant health problem throughout the world, which already represents high annual mortality. By 2040, chronic viral hepatitis due to virus B and virus C and their complications cirrhosis and hepatocellular carcinoma will be more deadly than malaria, vitellogenesis-inhibiting hormone, and tuberculosis altogether. In this review, we analyze the global impact of chronic viral hepatitis with a focus on the most vulnerable groups, the goals set by the World Health Organization for the year 2030, and the key points to achieve them, such as timely access to antiviral treatment of direct-acting antiviral, which represents the key to achieving hepatitis C virus elimination. Likewise, we review the strategies to prevent transmission and achieve control of hepatitis B virus. Finally, we address the impact that the coronavirus disease 2019 pandemic has had on implementing elimination strategies and the advantages of implementing telemedicine programs.
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MESH Headings
- Antiviral Agents/therapeutic use
- COVID-19
- Hepatitis B, Chronic/diagnosis
- Hepatitis B, Chronic/drug therapy
- Hepatitis B, Chronic/epidemiology
- Hepatitis C, Chronic/diagnosis
- Hepatitis C, Chronic/drug therapy
- Hepatitis C, Chronic/epidemiology
- Hepatitis, Viral, Human/diagnosis
- Hepatitis, Viral, Human/drug therapy
- Hepatitis, Viral, Human/epidemiology
- Humans
- Liver Neoplasms/drug therapy
- Liver Neoplasms/epidemiology
- Liver Neoplasms/prevention & control
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Affiliation(s)
| | | | - Luis Servín-Abad
- Department of Gastroenterology, Saint Cloud Hospital, Saint Cloud, MN 56303, United States
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