The prevalence of hepatitis C virus (HCV) infection in HIV-positive individuals in the UK - trends in HCV testing and the impact of HCV on HIV treatment outcomes

被引:34
作者
Turner, J. [2 ,3 ]
Bansi, L. [1 ]
Gilson, R. [2 ,3 ]
Gazzard, B. [4 ]
Walsh, J. [5 ]
Pillay, D. [6 ]
Orkin, C. [7 ]
Phillips, A.
Easterbrook, P. [8 ]
Johnson, M. [9 ]
Porter, K. [10 ]
Schwenk, A. [11 ]
Hill, T. [2 ,3 ]
Leen, C. [12 ]
Anderson, J. [13 ]
Fisher, M. [14 ]
Sabin, C. [2 ,3 ]
机构
[1] UCL, Sch Med, HIV Epidemiol & Biostat Grp, Res Dept Infect & Populat Hlth, London NW3 2PF, England
[2] UCL, Sch Med, Ctr Sexual Hlth & HIV Res, London NW3 2PF, England
[3] Mortimer Market Ctr, London, England
[4] Chelsea & Westminster NHS Trust, London, England
[5] Imperial Coll Healthcare NHS Trust, London, England
[6] UCL, Dept Virol, London NW3 2PF, England
[7] Barts & London NHS Trust, London, England
[8] Kings Coll Hosp London, London, England
[9] Royal Free NHS Trust, London, England
[10] Med Res Council Clin Trials Unit, London, England
[11] N Middlesex Univ Hosp NHS Trust, London, England
[12] Lothian Univ Hosp NHS Trust, Edinburgh, Midlothian, Scotland
[13] Homerton Univ Hosp NHS Trust, London, England
[14] Brighton & Sussex Univ Hosp NHS Trust, Brighton, E Sussex, England
基金
英国医学研究理事会;
关键词
cohort; HCV; hepatitis C; HIV; HUMAN-IMMUNODEFICIENCY-VIRUS; ACTIVE ANTIRETROVIRAL THERAPY; FIBROSIS PROGRESSION; NATURAL-HISTORY; LIVER FIBROSIS; COINFECTION; HEPATOTOXICITY; MORTALITY; RECOVERY; DISEASE;
D O I
10.1111/j.1365-2893.2009.01215.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
We examined the prevalence of hepatitis C virus (HCV) infection among HIV-positive individuals in the UK, trends in HCV testing and the impact of HCV on HIV treatment outcomes. Trends over time in HCV prevalence were calculated using each patient's most recent HCV status at the end of each calendar year. Logistic regression was used to identify factors associated with having a HCV antibody test, and Cox regression was used to determine whether HCV status was associated with the time to experiencing an immunological response to highly active antiretroviral treatment (HAART), time to virological response and viral rebound. Of the 31 765 HIV-positive individuals seen for care between January 1996 and September 2007, 20 365 (64.1%) individuals were tested for HCV, and 1807 (8.9%) had detectable HCV antibody. The proportion of patients in follow-up ever tested for HCV increased over time, from 782/8505 (9.2%) in 1996 to 14 280/17 872 (79.9%) in 2007. Nine thousand six hundred and sixty-nine individuals started HAART for the first time in or after January 2000, of whom, 396 (4.1%) were HCV positive. Presence of HCV infection did not affect initial virological response, virological rebound or immunological response. The cumulative prevalence of HCV in the UK CHIC Study is 8.9%. Despite UK guidelines, over 20% of HIV-positive individuals have not had their HCV status determined by 2007. HCV infection had no impact on HIV virological outcomes or immunological response to HIV treatment. The long-term impact on morbidity and mortality remain to be determined.
引用
收藏
页码:569 / 577
页数:9
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