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 23 November 2017

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News

HIV and hepatitis C coinfection within the CAESAR study

People with HIV and a history of intravenous drug use or elevated liver function tests should be targeted for hepatitis C testing, find investigators in the May issue of HIV Medicine.

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There is a declining incidence of AIDS-related opportunistic diseases in people with HIV infection. This has shifted the focus of clinical management toward prevention and treatment of comorbidities.

The increased risk of hepatitis C virus (HCV)-related advanced liver disease in people with HIV infection makes early HCV diagnosis a priority.

In this study, investigators from Australia and England assessed HCV prevalence and predictors of HIV/HCV coinfection.

The team conducted a retrospective analysis of people enrolled in the CAESAR (Canada, Australia, Europe, South Africa) study. This is a multinational randomized placebo-controlled study of the addition of lamivudine to background antiretroviral therapy.

In addition, the team evaluated the impact of HCV on HIV disease progression.
HIV/HCV coinfection was low in homosexual men.
HIV Medicine

The investigators determined that study participants had an HIV/HCV coinfection prevalence of 16%. This varied from 2% in South Africa to 49% in Italy.

The team found that the strongest predictor of HIV/HCV coinfection was HIV exposure category: injecting drug use (IDU), transfusion or blood products, or both homosexuality and IDU.

They established that HIV/HCV coinfection was low (4%) in homosexual men without reported IDU.

Other predictors of coinfection were alanine aminotransferase (ALT), country of residence, ethnicity, and stage of HIV disease.

The team found that HIV disease progression was similar in HIV monoinfected and HIV/HCV coinfected patients.

Dr Amin's team concluded, "People with HIV and a history of IDU or elevated liver function tests should be targeted for HCV testing".

"The low prevalence of HIV/HCV coinfection among homosexual men without a history of IDU suggests low efficiency of sexual HCV transmission".

HIV Medicine 2004; 5(3): 174-9
18 May 2004

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