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J Viral Hepat. 2017 Mar;24(3):187-196. doi: 10.1111/jvh.12630. Epub 2016 Dec 5.

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

Author information

1
TREAT Asia, amfAR - The Foundation for AIDS Research, Bangkok, Thailand.
2
Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
3
Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
4
HIVNAT, the Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
5
Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
6
National Hospital of Tropical Diseases, Hanoi, Vietnam.
7
University of Malaya Medical Centre, Kuala Lumpur, Malaysia.
8
The Kirby Institute, UNSW Australia, Sydney, NSW, Australia.
9
Faculty of Medicine, Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia.

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).

KEYWORDS:

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

PMID:
27917597
PMCID:
PMC5272750
DOI:
10.1111/jvh.12630
[Indexed for MEDLINE]
Free PMC Article

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