Zdroj: |
Mocroft, A, Lundgren, J, Gerstoft, J, Rasmussen, L D, Bhagani, S, Aho, I, Pradier, C, Bogner, J R, Mussini, C, Uberti Foppa, C, Maltez, F, Laguno, M, Wandeler, G, Falconer, K, Trofimova, T, Borodulina, E, Jevtovic, D, Bakowska, E, Kase, K, Kyselyova, G, Haubrich, R, Rockstroh, J K, Peters, L, EuroSIDA Study, Losso, M, Kundro, M, Schmied, B, Kronborg, G, Benfield, T, Katzenstein, T L, Pedersen, C, Johansen, I S, Østergaard, L, Wiese, L, Møller, N F, Nielsen, L N, Scullard, G, Clarke, A & Leen, C 2020, ' Clinical Outcomes in Persons Coinfected With Human Immunodeficiency Virus and Hepatitis C Virus : Impact of Hepatitis C Virus Treatment ', Clinical Infectious Diseases, vol. 70, no. 10, pp. 2131-2140 . https://doi.org/10.1093/cid/ciz601 |
Popis: |
BACKGROUND: A hepatitis C (HCV) cure is associated with changes in lipids and inflammatory biomarkers, but its impact on clinical endpoints among treated human immunodeficiency virus (HIV)/HCV coinfected persons is unclear.METHODS: People living with HIV from EuroSIDA with a known HCV status after January 2001 were classified into strata based on time-updated HCV RNA measurements and HCV treatment, as either HCV antibody-negative; spontaneously resolved HCV; chronic, untreated HCV; cured HCV (HCV RNA-negative); or HCV treatment failures (HCV RNA-positive). Poisson regression was used to compare incidence rates between HCV groups for end-stage liver disease (ESLD; including hepatocellular carcinoma [HCC]), non-acquired immunodeficiency virus defining malignancy (NADM; excluding HCC), and cardiovascular disease (CVD).RESULTS: There were 16 618 persons included (median follow-up 8.3 years, interquartile range 3.1-13.7). There were 887 CVD, 902 NADM, and 436 ESLD events; crude incidence rates/1000 person-years follow-up were 6.4 (95% confidence interval [CI] 6.0-6.9) for CVD, 6.5 (95% CI 6.1-6.9) for NADM, and 3.1 (95% CI 2.8-3.4) for ESLD. After adjustment, there were no differences in incidence rates of NADM or CVD across the 5 groups. HCV-negative individuals (adjusted incidence rate ratio [aIRR] 0.22, 95% CI 0.14-0.34) and those with spontaneous clearance (aIRR 0.61, 95% CI 0.36-1.02) had reduced rates of ESLD compared to cured individuals. Persons with chronic, untreated HCV infections (aIRR 1.47, 95% CI 1.02-2.13) or treatment failure (aIRR 1.80, 95% CI 1.22-2.66) had significantly raised rates of ESLD, compared to those who were cured.CONCLUSIONS: Incidences of NADM or CVD were independent of HCV group, whereas those cured had substantially lower incidences of ESLD, underlining the importance of successful HCV treatment for reducing ESLD. |