Impact of human immunodeficiency virus infection in patients infected with the hepatitis C virus

Tovo, Cristiane Valle; Mattos, Ângelo Alves de; Souza, Andrea Ribeiro de; Rigo, Juliana Ferrari de Oliveira; Almeida, Paulo Roberto Lerias de; Galperim, Bruno

doi:10.1111/j.1478-3231.2006.01344.x

Cited by 22 publications

(19 citation statements)

References 56 publications

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“…On the other hand, other authors have demonstrated that the progression of liver disease in HIV/HCV coinfected patients occurs primarily when the HIV infection is inadequately managed [12,13]. Confirming this hypothesis, Tovo et al assessed 385 HIV/HCV coinfected patients, and observed a similar fibrosis progression rate to that of HCV or HIV monoinfected patients [14].…”

Section: Introductionsupporting

confidence: 56%

Antiretroviral therapy does not affect response to chronic hepatitis C therapy in HIV-coinfected patients

Leon

Tovo

Kliemann

et al. 2016

J Infect Dev Ctries

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Introduction: Many patients coinfected with the human immunodeficiency virus (HIV) and hepatitis C virus (HCV) are using highly active antiretroviral therapy (HAART) and HCV therapy with peginterferon (PEG-IFN) and ribavirina (RBV) because the use of direct-acting antivirals is not a reality in some countries. To know the impact of such medications in the sustained virological response (SVR) during HCV treatment is of great importance. Methodology: This was a retrospective cohort study of 215 coinfected HIV/HCV patients. The patients were treated with PEG-IFN and RBV between 2007 and 2013 and analyzed by intention to treat. Treatment-experienced patients to HCV and carriers of hepatitis B were excluded. Demographic data (gender, age), mode of infection, HCV genotype, HCV viral load, hepatic fibrosis, HIV status, and type of PEG were evaluated. One hundred eighty-eight (87.4%) patients were using HAART. Results: SVR was achieved in 55 (29.3%) patients using HAART and in 9 (33.3%) patients not using HAART (p = 0.86). There was no difference in SVR between different HAART medications and regimens using two reverse transcriptase inhibitor nucleosides (NRTIs) or the use of protease inhibitors and non-NRTIs (27.1% versus 31.5%; p = 0.61). The predictive factors for obtaining SVR were low HCV viral load, non-1 genotype, and the use of peginterferon-α2a. Conclusions: The use of HAART does not influence the SVR of HCV under PEG-IFN and RBV therapy in HIV/HCV coinfected patients.

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Section: Introductionsupporting

confidence: 56%

Antiretroviral therapy does not affect response to chronic hepatitis C therapy in HIV-coinfected patients

Leon

Tovo

Kliemann

et al. 2016

J Infect Dev Ctries

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“…On the other hand, HAART may enhance liver damage in some HIV-HCV coinfected individuals through drug-related hepatotoxicity. Only 6 studies [28,32,35,38,39,42] in our analysis introduced the state of HAART in patients with HIV-HCV co-infection. The proportion of patients who were receiving HAART in cohort ranged 83%-95%.…”

Section: Discussionmentioning

confidence: 99%

“…Of them, 6242 were positive for HIV and 10508 were negative for HIV. Fourteen studies assessed the histological cirrhosis [9,18,19,21,[27][28][29][30][31][32]38,39,41,42] , 7 studies assessed the death [17,22,23,[34][35][36]40] , 3 studies assessed the decompensated liver disease [15,26,37] , 2 studies assessed the outcome of decompensated liver disease and death [16][17][18][19][20][21][22][23][24][25] , 1 study assessed the outcome of histological cirrhosis, hepatocellular carcinoma and death [20] , 1 study assessed the outcome of histological cirrhosis and death [24] , and 1 study assessed the outcome of hepatocellular carcinoma and death [33] , respectively. Most studies did not provide a racial distribution.…”

Section: Deng Lp Et Al Impact Of Hiv Infection On Hcv Infectionmentioning

confidence: 99%

Impact of human immunodeficiency virus infection on the course of hepatitis C virus infection: A meta-analysis

Deng¹,

Gui²,

Zhang³

et al. 2009

WJG

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AIM:To analyze the influence of human immunodeficiency virus (HIV) infection on the course of hepatitis C virus (HCV) infection. METHODS:We performed a meta-analysis to quantify the effect of HIV co-infection on progressive liver disease in patients with HCV infection. Published studies in the English or Chinese-language medical literature involving cohorts of HIV-negative and -positive patients coinfected with HCV were obtained by searching the PUBMED, EMBASE and CBM. Data were extracted independently from relevant studies by 2 investigators and used in a fixed-effect meta analysis to determine the difference in the course of HCV infection in the 2 groups. RESULTS:Twenty-nine trails involving 16 750 patients were identified including the outcome of histological fibrosis or cirrhosis or de-compensated liver disease or hepatocellular carcinoma or death. These studies yielded a combined adjusted odds ratio (OR) of 3.40 [95% confidence interval (CI) = 2.45 and 4.73]. Of note, studies that examined histological fibrosis/ cirrhosis, decompensated liver disease, hepatocellular carcinoma or death had a pooled OR of 1.47 (95% CI = 1.27 and 1.70), 5.45 (95% CI = 2.54 and 11.71), 0.76 (95% CI = 0.50 and 1.14), and 3.60 (95% CI = 3.12 and 4.15), respectively. CONCLUSION:Without highly active antiretroviral therapies (HAART), HIV accelerates HCV disease progression, including death, histological fibrosis/ cirrhosis and decompensated liver disease. However, the rate of hepatocellular carcinoma is similar in persons who had HCV infection and were positive for HIV or negative for HIV.

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“…The increase in patient survival numbers following the introduction of highly active antiretroviral therapy (HAART) has seen the emergence of HCV infection and chronic hepatic diseases as important morbidity and mortality causes together with HIV [2,3]. Similar transmission routes for HIV and HCV mean that coinfection is currently common, especially in injecting drug users and patients who have undergone blood transfusions, differing slightly from risk groups with isolated HIV or HCV [2,4,5]. It is estimated that 30% to 35% of HIV-infected patients in the United States of America are coinfected with HCV [2,6].…”

Section: Introductionmentioning

confidence: 99%

HAART and liver: is it safe?

Antonello¹,

Kliemann

Santos

et al. 2014

J Infect Dev Ctries

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Introduction: Liver disease caused by hepatitis C virus (HCV) is a major cause of morbidity in HIV patients. This study investigates the possibility that chronic HCV increases the risk of hepatotoxicity after highly active antiretroviral therapy (HAART) initiation. Methodology: The data from 30 coinfected HIV/HCV and 35 HIV monoinfected patients between August 2008 and August 2010, since the start of HAART, were analyzed along with data from every three months, with clinical/laboratory evaluation until the end of twelve months. The aim of this study was to assess risk and incidence of hepatotoxicity in both groups. Results: Before the introduction of HAART, coinfected patients had higher average levels of transaminases than did the monoinfected group (p < 0.001). After initiation of HAART, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were higher in coinfected patients, regardless of type of HAART they received. Twenty-two (73%) of the coinfected patients had some degree of hepatotoxicity versus only seven (20%) of the monoinfected patients. No patient had severe hepatotoxicity. Risk of hepatotoxicity after HAART in a coinfected patient was 3.7 times higher than in a monoinfected patient .4], p < 0.001).Conclusions: This study demonstrates that coinfected patients are at an increased risk for developing hepatotoxicity, but the clinical and immunological benefits of HAART are higher than the risk of hepatotoxicity and rarely justify discontinuation of therapy.

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Impact of human immunodeficiency virus infection in patients infected with the hepatitis C virus

Abstract: In the present series there was no relevant impact of HCV infection in patients with HIV.

Cited by 22 publications

References 56 publications

Antiretroviral therapy does not affect response to chronic hepatitis C therapy in HIV-coinfected patients

Antiretroviral therapy does not affect response to chronic hepatitis C therapy in HIV-coinfected patients

Impact of human immunodeficiency virus infection on the course of hepatitis C virus infection: A meta-analysis

HAART and liver: is it safe?

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