of Hepatitis C in HIV Outpatient Study
Only about 1 in 5 HIV/HCV coinfected participants in the
HOPS cohort received hepatitis C treatment, though the proportion
increased over time.
the advent of effective combination antiretroviral therapy,
liver disease due to viral hepatitis has become a leading cause
of non-AIDS-related morbidity and mortality among HIV
positive people. HIV/HCV
coinfected people tend to experience more rapid liver disease
progression and do not respond as well to interferon-based
therapy as individuals with HCV
In the May
2011 Journal of Viral Hepatitis, C. Vellozzi from
the Centers for Disease Control and Prevention (CDC) and colleagues
reported results from a study looking at the frequency and predictors
of hepatitis C treatment initiation among coinfected participants
enrolled in the HIV Outpatient Study (HOPS) during 1999-2007.
Participants were followed for an average of about 4 years.
participants, or 20% of HIV/HCV coinfected patients in the
HOPS cohort, started hepatitis C treatment during follow-up.
a multivariate analysis, black (non-Hispanic) race/ethnicity
was independently associated with lower likelihood of starting
hepatitis C treatment (hazard ratio [HR] 0.3).
elevated ALT (HR 3.5) and a CD4 T-cell count of at least
500 cells/mm3 (HR 1.8) at study entry independently predicted
higher likelihood of treatment.
An increasing proportion of patients started hepatitis C
treatment as time went on.
of patients who started observation during 1999-2001 started
treatment during the first year of follow-up, compared with
11% who started during 2002-2004 and 21% who started during
1999 and 2007, despite a stable low fraction of patients coinfected
with HCV/HIV initiating treatment for HCV infection, an increasing
proportion initiated treatment within the first year after the
infection was confirmed," the study authors concluded.
"Treatment of HCV infection in patients coinfected with
HCV/HIV should be considered a priority, given the increased
risk of accelerated end-stage liver disease."
Investigator affiliations: Division of HIV/AIDS Prevention,
National Center for HIV, STD and TB Prevention, Centers for
Disease Control and Prevention, Atlanta, GA; Cerner Corporation,
Vienna, VA; Division of Viral Hepatitis, National Center for
HIV, STD and TB Prevention, Centers for Disease Control and
Prevention, Atlanta, GA; Temple University, Philadelphia, PA.
C Vellozzi, K Buchacz, R Baker, et al. Treatment of hepatitis
C virus (HCV) infection in patients coinfected with HIV in the
HIV Outpatient Study (HOPS), 1999-2007. Journal of Viral
Hepatitis 18(5):316-324 (abstract).