Coinfection

IAS 2013: People with HBV or HCV Coinfection May Not Respond as Well to HIV Treatment

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HIV positive people with hepatitis B or C coinfection in Asia had lower CD4 T-cell counts, saw smaller CD4 cell gains after starting antiretroviral therapy, and had a higher risk of death, researchers reported at the recent 7th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2013) in Kuala Lumpur.

Coinfection with HIV is associated with faster liver disease progression among people with hepatitis B or C, as well as poorer response to interferon-based hepatitis C treatment. Studies of the effect of hepatitis B or C on HIV disease progression have been less consistent, but most have seen little effect, especially among people on effective antiretroviral therapy (ART).

Yi-Ming Arthur Chen from Kaohsiung Medical University in Taiwan and colleagues looked at the effects of hepatitis B virus (HBV) and hepatitis C virus (HCV) coinfection on long-term outcomes following ART initiation among people in the Asia-Pacific region, where hepatitis B is highly endemic and hepatitis C is common.

The study included 7455 HIV positive patients from 21 hospitals in 12 Asian countries included in the TREAT Asia HIV Observational Database (TAHOD), who collectively contributed 24,798 total person-years of follow-up. People who had ever tested positive for hepatitis B surface antigen (HBsAg) or anti-HCV antibodies were considered coinfected.

Results

"In this Asian regional HIV cohort, patients with HBV or HCV coinfection had significantly lower CD4 counts [and] smaller CD4 increases after 180 days of ART," the researchers concluded.

"We need to test, identify, and initiate [highly active] ART early in HBV and HCV coinfected [patients] to have a better treatment effect," they recommended.

8/7/13

Reference

Y-MA Chen, Y-H Chen, Y-T Lin, et al. HBV and HCV co-infection: long term immunological, virological and survival outcomes following cART. 7th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention. Kuala Lumpur, June 30-July 3, 2013. Abstract TULBPE13.