Care of hepatitis C virus infection in human immunodeficiency virus-infected patients: Modifications in three consecutive large surveys between 2004 and 2009

Received 30 November 2009; received in revised form 9 February 2010; accepted 15 March 2010. published online 05 May 2010.

Background & Aims

To analyze the care of HCV infection in HIV–HCV coinfected patients and its progression between 2004 and 2009.

Methods

Three hundred eighty HIV–HCV coinfected patients were prospectively included from November 22 to 29, 2004 (2004 survey), 416 patients from April 3 to 10, 2006 (2006 survey), and 419 patients from June 15 to 22, 2009 (2009 survey).

Results

The rate of liver biopsy decreased (14% vs. 38% vs. 56%), while the use of non-invasive liver damage tests increased (47% vs. 24% vs. ND) in the 2009, 2006, and 2004 surveys, respectively. The rate of patients that had never been treated for HCV infection progressively decreased in the 2009, 2006, and 2004 surveys (37%, 42%, and 54%). The main reasons for HCV non-treatment changed as HCV treatment was deemed less questionable and the lack of liver biopsy became a very rare reason (6%, 18%, and 34%). Among patients treated for HCV infection, the rate of sustained virological response increased (49%, 29%, and 29%). The main factors independently associated with HCV treatment were a liver fibrosis score ⩾F2 (odds ratio=3.5; 95% CI 2.1–5.7), a liver biopsy activity grade ⩾A2 (2.7; 1.4–5.3), a CD4 cell count ⩾350ml (2.7; 1.6–4.4), European origin (2.1; 1.3–3.4), daily alcohol consumption<30g (2.1; 1.2–3.8), and male gender (2.0; 1.2–3.3).

Conclusion

Compared to the 2004 and 2006 surveys, the 2009 coinfected patients had liver damage assessment more frequently, more patients had received HCV treatment and more patients had achieved a sustained virological response.

Keywords: HIV, HCV, Coinfection, Treatment, Interferon

1 Université Pierre et Marie Curie-Paris6, CNRS, UMR 7211, France

2 AP-HP, Hôpital Pitié-Salpêtrière, Service de Médecine Interne, Paris F-75013, France

3 Laboratoire Alphabio, Marseille, France

4 Service de Médecine Interne, Hôpital de l’Archet, Nice, France

5 Service d’Hépatogastroentérologie Hotel Dieu, Lyon, France

6 Service de Maladies Infectieuses, Hôpital Tenon, Paris, France

7 Service d’Hépatogastroentérologie, Hôpital de la Pitié-Salpêtrière, Paris, France

8 Centre National de Référence des Hépatites Virales B, C et Delta, Laboratoire de Virologie et INSERM U955, Hôpital Henri Mondor, Université Paris 12, Créteil, France

9 Service de Maladies Infectieuses, Dijon, France

10 Service de Maladies Infectieuses, Nancy, France

11 Service d’Hépatologie, Hôpital Cochin, Université René Descartes Paris V and INSERM U567, Paris, France

Corresponding author. Address: AP-HP, Hôpital Pitié-Salpêtrière, Service de Médecine Interne, Paris F-75013 France. Tel.: + 33 1 42 17 80 27; fax: + 33 1 42 17 80 33.

PII: S0168-8278(10)00326-0

doi:10.1016/j.jhep.2010.03.009

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