HIV coinfection shortens the survival of patients with hepatitis C virus‐related decompensated cirrhosis†

Pineda, Juan A.; Romero‐Gómez, Manuel; Díaz-García, F.; Girón-González, José A.; Montero, J.L.; Torre‐Cisneros, Julián; Andrade, Raúl J.; González-Serrano, Mercedes; Aguilar, José Manuel Varela; Aguilar‐Guisado, Manuela; Navarro, José María; Salmerón, Javier; Caballero-Granado, Francisco Javier; García‐García, José A.

doi:10.1002/hep.20626

Cited by 257 publications

(189 citation statements)

References 36 publications

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“…110 The median survival of decompensated cirrhosis in patients with HIV and HCV coinfection is only 13 months. 111 With newer developments in the management of both HIV as well as HCV, the natural history of HCV and HIV coinfection is likely to change and might resemble HCV monoinfected patients. 112 With the introduction of DAA against HCV, the mechanism of action of HCV therapies has shifted from immune-regulation by PEG-IFNa/RBV therapy to direct viral inhibition.…”

Section: Management Of Hcv In Hiv Coinfectionmentioning

confidence: 99%

Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

Puri

Saraswat

Dhiman

et al. 2016

Journal of Clinical and Experimental Hepatology

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India contributes significantly to the global burden of HCV. While the nucleoside NS5B inhibitor sofosbuvir became available in the Indian market in March 2015, the other directly acting agents (DAAs), Ledipasvir and Daclatasvir, have only recently become available in the India. The introduction of these DAA in India at a relatively affordable price has led to great optimism about prospects of cure for these patients as not only will they provide higher efficacy, but combination DAAs as all-oral regimen will result in lower side effects than were seen with pegylated interferon alfa and ribavirin therapy. Availability of these newer DAAs has necessitated revision of INASL guidelines for the treatment of HCV published in 2015. Current considerations for the treatment of HCV in India include the poorer response of genotype 3, nonavailability of many of the DAAs recommended by other guidelines and the cost of therapy. The availability of combination DAA therapy has simplified therapy of HCV with decreased reliance of evaluation for monitoring viral kinetics or drug related side effects. ( J CLIN EXP HEPATOL 2016;6:119-145) T here have been revolutionary changes in the management of chronic hepatitis C (CH-C) over the last few years. Pegylated interferon alfa (Peg-IFNa) plus ribavirin (RBV) therapy, which till the recent past was the standard of care, has been eclipsed by the arrival of newer directly acting antiviral agents (DAAs). Not only do the DAAs have better efficacy, they are also associated with lower side effects, have better tolerability, a shorter duration of therapy, and have simpler administration.In the recent guidelines issued by the American Association for the study of Liver Diseases (AASLD), in collaboration with the Infectious Diseases Society of America 1 and the European Association for Study of the Liver z (EASL), 2 the role of Peg-IFNa/RBV therapy in the management of HCV has been relegated to second-line, backup status. These newer guidelines, however, cannot be implemented in India as many of the recommended drugs are yet to be marketed in India. Other considerations for the treatment of HCV in India are a predominance of

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Section: Management Of Hcv In Hiv Coinfectionmentioning

confidence: 99%

Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

Puri

Saraswat

Dhiman

et al. 2016

Journal of Clinical and Experimental Hepatology

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“…Liver disease is one of the major causes of morbidity and mortality in HIV-infected patients [75,76], and its severity has been associated with more advanced immunosuppression. HCV/HIV co-infection may accelerate HIV-related neurocognitive decline [69].…”

Section: Co-infection With Hepatic Virusesmentioning

confidence: 99%

Italian Consensus Statement on Management of HIV-Infected Individuals with Advanced Disease Naïve to Antiretroviral Therapy

et al. 2009

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“…9,10 In subsets of patients who have undergone liver transplantation, who have human immunodeficiency virus coinfection, or those on hemodialysis, HCV is associated with significantly shortened survival. [11][12][13][14][15][16] Treatment for chronic HCV has been found to be cost-effective 17 and is associated with sustained viral clearance in approximately 54% to 63% of patients overall. [18][19][20][21] However, the effect of HCV infection itself and its treatment on longterm survival is not well known.…”

mentioning

confidence: 99%

Effect of hepatitis C virus and its treatment on survival†‡

Butt

Moore

2009

Hepatology

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The effect of hepatitis C virus (HCV) and its treatment on survival is not well defined. We undertook this study to determine the effect of HCV and its treatment on survival in a national cohort of HCV-infected veterans and uninfected controls. We used a national sample of HCV-infected persons and HCV-uninfected controls from the Electronically Retrieved Cohort of HCV Infected Veterans (ERCHIVES) to compare survival between the two groups. We also compared the effect of treatment and treatment duration on survival in the HCV-infected group. We used matched Cox proportional hazards model to determine the predictors of mortality. Kaplan-Meier survival plots were generated to determine and compare survival among HCV-infected and HCV-uninfected persons, and among treated and untreated HCV-infected persons. We identified 34,480 matched pairs of HCV-infected subjects and controls. HCV infection was independently associated with a higher risk of mortality (hazards ratio, 1.37; 95% confidence interval, 1.31-1.47). Subjects treated for 48 weeks or longer had the lowest mortality among HCV-infected subjects (hazards ratio, 0.41; 95% confidence interval, 0.27-0.64), whereas those who received less than 48 week of treatment had intermediate mortality ( I t is estimated that more than 170 million persons are infected with the hepatitis C virus (HCV) worldwide. 1 HCV infection is a leading cause of liver cirrhosis, end-stage liver disease, hepatocellular carcinoma, and liver transplantation. 2,3 Treatment for HCV is associated with a reduced risk of liver disease progression and a lower incidence of hepatocellular carcinoma, even when the treatment does not achieve viral eradication. [4][5][6] The impact of HCV infection on survival in the general population is controversial. Some studies have shown a significant increase in mortality in HCV-infected persons, 7,8 whereas others have shown relatively low mortality rate and liver disease progression in otherwise healthy persons. 9,10 In subsets of patients who have undergone liver transplantation, who have human immunodeficiency virus coinfection, or those on hemodialysis, HCV is associated with significantly shortened survival. [11][12][13][14][15][16] Treatment for chronic HCV has been found to be cost-effective 17 and is associated with sustained viral clearance in approximately 54% to 63% of patients overall. [18][19][20][21] However, the effect of HCV infection itself and its treatment on longterm survival is not well known. We used a large national electronically retrieved cohort of HCV infected veterans (ERCHIVES) to compare survival between HCV-infected and HCV-uninfected subjects and to determine the effect of HCV treatment on survival within the HCVinfected subjects. Our study does not attempt to define or determine the appropriateness of treatment initiation,

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HIV coinfection shortens the survival of patients with hepatitis C virus‐related decompensated cirrhosis†

Cited by 257 publications

References 36 publications

Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

Italian Consensus Statement on Management of HIV-Infected Individuals with Advanced Disease Naïve to Antiretroviral Therapy

Effect of hepatitis C virus and its treatment on survival†‡

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