Chronic hepatitis C infection and liver disease in HIV-coinfected patients in Asia

N. Durier, Evy Yunihastuti, K. Ruxrungtham, N. V. Kinh, A. Kamarulzaman, D. Boettiger, Alvina Widhani, A. Avihingsanon, B. V. Huy, S. F.B. Syed Omar, A. Sanityoso, S. Chittmittrapap, N. T.H. Dung, V. Pillai, T. Suwan-Ampai, M. Law, A. H. Sohn, G. Matthews

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3 Citations (Scopus)

Abstract

Data on markers of hepatitis C virus (HCV) disease in HIV-HCV-coinfected patients in resource-limited settings are scarce. We assessed HCV RNA, HCV genotype (GT), IL28B GT and liver fibrosis (FibroScan®) in 480 HIV-infected patients with positive HCV antibody in four HIV treatment centres in South-East Asia. We enrolled 165 (34.4%) patients in Jakarta, 158 (32.9%) in Bangkok, 110 (22.9%) in Hanoi and 47 (9.8%) in Kuala Lumpur. Overall, 426 (88.8%) were male, the median (IQR) age was 38.1 (34.7-42.5) years, 365 (76.0%) reported HCV exposure through injecting drug use, and 453 (94.4%) were on combination antiretroviral therapy. The median (IQR) CD4 count was 446 (325-614) cells/mm3 and 208 (94.1%) of 221 patients tested had HIV-1 RNA <400 copies/mL. A total of 412 (85.8%) had detectable HCV RNA, at a median (IQR) of 6.2 (5.4-6.6) log10 IU/mL. Among 380 patients with HCV GT, 223 (58.7%) had GT1, 97 (25.5%) had GT3, 43 (11.3%) had GT6, eight (2.1%) had GT4, two (0.5%) had GT2, and seven (1.8%) had indeterminate GT. Of 222 patients with IL28B testing, 189 (85.1%) had rs12979860 CC genotype, and 199 (89.6%) had rs8099917 TT genotype. Of 380 patients with FibroScan®, 143 (37.6%) had no/mild liver fibrosis (F0-F1), 83 (21.8%) had moderate fibrosis (F2), 74 (19.5%) had severe fibrosis (F3), and 79 (20.8%) had cirrhosis (F4). One patient (0.3%) had FibroScan® failure. In conclusion, a high proportion of HIV-HCV-coinfected patients had chronic HCV infection. HCV GT1 was predominant, and 62% of patients had liver disease warranting prompt treatment (≥F2).

Original languageEnglish
Pages (from-to)187-196
Number of pages10
JournalJournal of Viral Hepatitis
Volume24
Issue number3
DOIs
Publication statusPublished - 1 Mar 2017

Keywords

  • Asia
  • HIV
  • chronic infection
  • fibrosis
  • hepatitis C virus

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