Direct-acting antiviral therapy was safe and highly effective in patients coinfected with HIV and hepatitis C, according to a recently published study. Factors that negatively affected sustained virologic response rates included HIV-related immunosuppression, HCV RNA load, severity of liver disease and suboptimal DAA-based regimens.
“Concern has been raised about the generalizability of inclusion criteria from clinical trials of different DAAs to the highly heterogeneous population of HIV/HCV-coinfected patients,” Juan Berenguer, MD, PhD, from the Hospital General Universitario Gregorio Marañón, Spain, and colleagues wrote. “We evaluated the response to treatment in a large prospective registry of HIV/HCV-coinfected persons receiving DAA-based HCV therapy in the region of Madrid (Spain) and analyzed factors associated with treatment failure.”
Berenguer and colleagues prospectively followed 2,396 patients with HIV/HCV-coinfection during treatment. Median patient age was 51 years, 78.2% were men, 63.9% were treatment-naive, 803 had compensated cirrhosis and 156 had decompensated cirrhosis. Patients had HCV genotype 1a (40.9%), 1b (15.1%), 3 (15%) or 4 (22.4%).
Note: Bravo for coffee – just be sure to skip the cream and sugar or go lightly on them.
A wealth of studies have hailed coffee for its potential health benefits, but for patients infected with both HIV and hepatitis C virus, the rewards could be even greater; a new study suggests that drinking at least three cups of coffee per day could halve their risk of all-cause mortality.
The researchers also found that quitting smoking further boosted survival for these patients, even after the clearance of hepatitis C virus (HCV).
Lead investigator Dominique Salmon-Céron, Ph.D. – of the Service des Maladies Infectieuses et Tropicales, Hôpital Cochin, and Université Paris Descartes in France – and colleagues recently reported their findings in the Journal of Hepatology.
Alcohol dependence presents a significant barrier to hepatitis C treatment among patients with HIV compared with non-alcohol substance dependence, according to a presentation at the International Symposium on Hepatitis Care in Substance Users.
According to the presentation by Kyle W. Prochno, a research coordinator from the Icahn School of Medicine at Mount Sinai, New York, alcohol-specific dependence was particularly prohibitive to HCV treatment initiation among patients with HIV, even when applying a treatment initiation-promoting intervention.
The study comprised 53 patients with HCV/HIV coinfection who had not engaged in HCV treatment within 12 months. Mean patient age was 53.9 years, 71.7% were men, 49.1% were Hispanic and 41.5% were black. Overall, 81.1% received a diagnosis of lifetime substance dependence, including cocaine (69.8%), alcohol (47.2%) and opioids (47.2%).
Homeless veterans in the United States have a significantly higher prevalence of infection with HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) compared to non-homeless veterans, investigators report in the online edition of Clinical Infectious Diseases. Prevalence of these viral infections was up to three times higher among homeless veterans compared to non-homeless veterans.
“Veterans who use homeless services clearly comprise a population with increased prevalence of HIV, HCV and HBV,” comment the authors. “A veteran’s involvement with homeless services provides a unique opportunity for engagement with other healthcare services, potentially using an integrated, co-located clinic model in a comprehensive approach.”
It is well established that HIV, HCV and HBV disproportionately affect armed forces veterans in the United States. Homeless individuals are at particularly high risk of infection with these blood-borne viruses due to overlapping risk factors, including mental health disorders and substance abuse.
Study on otherwise highly effective drugs being published in Journal of Hepatology
KINGSTON, R.I., December 13, 2016 — In the past few years, the normally reticent scientific community heralded as revolutionary new medications for Hepatitis C, saying the drugs would bring a major shift in the treatment of the chronic and potentially fatal viral infection that affects 150 million people worldwide.
They were right. These direct-acting drugs, which attack the processes that fueled the virus’s growth, resulted in cure rates well over 95 percent in a matter of weeks to a few months. They also gave new hope to the many people co-infected with HIV as well as Hepatitis C, who could now rid their bodies of the latter.
NEWARK >> A former New Jersey Transit communications services coordinator received a $200,000 settlement stemming from a discrimination lawsuit.
Kenneth Hitchner, a nine-year employee at the public transit agency, disclosed when he was hired as a public information officer in 2002 that he had hemophilia, Hepatitis C and was HIV positive, according to a copy of the lawsuit obtained by The Trentonian.
Hitchner, who had received raises and benefits for his performance, began a six-month Hepatitis C treatment in September 2009, court documents indicate.
Jeffrey thought the battles in his life were over. But following his service in Iraq as a combat soldier, Jeffrey fought drug addiction and was later diagnosed with HIV. The next blow came when he learned that he was infected with the Hepatitis C virus (HCV), a blood-borne virus that can cause chronic liver disease, serious liver damage, and liver failure.
Jeffrey joined Amida Care — New York’s largest Medicaid special needs health plan for people living with chronic health conditions such as HIV/AIDS — and was able to take control of his health through holistic care. Through Amida Care, Jeffrey was also able to access groundbreaking treatment that cured him of HCV in just 12 weeks.
Not everyone has this opportunity, however — the high price of HCV medication keeps it out of reach for many. July 28 is World Hepatitis Day, which brings awareness to the goal of eliminating viral hepatitis as a public health threat by the year 2030. Without increased access to treatment, this goal cannot be achieved, and the health of those living with HCV or who are co-infected with HIV and HCV will remain at risk.
SnapShots: Article: Prevalence and burden of HCV co-infection in people living with
HIV: a global systematic review and meta-analysis—L Platt et al.
Source: The Lancet Infectious Diseases, doi:10.1016/S1473-3099(15)00485-5,
published online 24 February 2016
Study Aim and Results
The aim of the study was to estimate the worldwide prevalence of HIV and hepatitis C coinfection. The World Health Organization estimates that the worldwide prevalence of HIV is 37 million and HCV is 115 million. The current study was commissioned by the World Health Organization.
The authors conducted a meta-analysis (combining various studies) that included (and excluded) prevalence data of HIV and hepatitis C coinfection. The studies had to be conducted between January 1, 2002, and January 28, 2015. The authors found 783 studies that met their inclusion criteria resulting in 902 estimates of the prevalence of HIV and hepatitis C coinfection.
Listed below are their estimates of worldwide rates of HIV and hepatitis C coinfection:
2,278,400 (1,271,300-4,417,000) people worldwide are coinfected with HIV and hepatitis C.
The majority were among people who inject drugs – 1,362,700 (847,700-1,381,800)
Coinfection in people with HIV – 2.4% (range 0.8 – 5.8%)
In people who inject drugs- 82.4% (55.2 -88.5%)
Men who have sex with men – 6.4% (3.2 – 10%)
Pregnant or heterosexually exposed samples- 4% (1.2 –8.4%)
The odds of having HCV infection were six times higher in people who were HIV positive than in people who were HIV negative. The higher prevalence rates of HIV and hepatitis C coinfection were found in countries of Eastern Europe where there are high rates of injection drug use and sub-Sahara where there is a high rate of HIV.
This study was a big undertaking. I am not sure anyone truly understands the true magnitude of hepatitis C worldwide. Many countries especially resource-poor countries have little to no HCV testing services. Even in the United States the true number of acute and chronic hepatitis C is believed to vastly under-reported.
Still, it is important to come up with a starting number to establish a baseline. This report should also prompt countries to establish programs to provide more testing and support services for people with hepatitis C and programs for HIV if not already in place.