Chronic hepatitis C infection and liver disease in HIV-coinfected patients in Asia.
Data on markers of hepatitis C virus (HCV) disease in HIV-HCV-coinfected patients in resource-limited settings are scarce. We assessed HCV RNA, HCV genotype (GT), IL28B GT and liver fibrosis (FibroScan® ) in 480 HIV-infected patients with positive HCV antibody in four HIV treatment centres in South-East Asia. We enrolled 165 (34.4%) patients in Jakarta, 158 (32.9%) in Bangkok, 110 (22.9%) in Hanoi and 47 (9.8%) in Kuala Lumpur. Overall, 426 (88.8%) were male, the median (IQR) age was 38.1 (34.7-42.5) years, 365 (76.0%) reported HCV exposure through injecting drug use, and 453 (94.4%) were on combination antiretroviral therapy. The median (IQR) CD4 count was 446 (325-614) cells/mm3 and 208 (94.1%) of 221 patients tested had HIV-1 RNA <400 copies/mL. A total of 412 (85.8%) had detectable HCV RNA, at a median (IQR) of 6.2 (5.4-6.6) log10 IU/mL. Among 380 patients with HCV GT, 223 (58.7%) had GT1, 97 (25.5%) had GT3, 43 (11.3%) had GT6, eight (2.1%) had GT4, two (0.5%) had GT2, and seven (1.8%) had indeterminate GT. Of 222 patients with IL28B testing, 189 (85.1%) had rs12979860 CC genotype, and 199 (89.6%) had rs8099917 TT genotype. Of 380 patients with FibroScan® , 143 (37.6%) had no/mild liver fibrosis (F0-F1), 83 (21.8%) had moderate fibrosis (F2), 74 (19.5%) had severe fibrosis (F3), and 79 (20.8%) had cirrhosis (F4). One patient (0.3%) had FibroScan® failure. In conclusion, a high proportion of HIV-HCV-coinfected patients had chronic HCV infection. HCV GT1 was predominant, and 62% of patients had liver disease warranting prompt treatment (≥F2).
['Durier|N|N|', 'Yunihastuti|E|E|', 'Ruxrungtham|K|K|', 'Kinh|N V|NV|', 'Kamarulzaman|A|A|', 'Boettiger|D|D|', 'Widhani|A|A|', 'Avihingsanon|A|A|', 'Huy|B V|BV|', 'Syed Omar|S F B|SF|', 'Sanityoso|A|A|', 'Chittmittrapap|S|S|', 'Dung|N T H|NT|', 'Pillai|V|V|', 'Suwan-Ampai|T|T|', 'Law|M|M|', 'Sohn|A H|AH|', 'Matthews|G|G|']
D000328:Adult D000483:Alleles D001210:Asia, Southeastern D018791:CD4 Lymphocyte Count D060085:Coinfection D005260:Female D005838:Genotype D015658:HIV Infections D016174:Hepacivirus D018937:Hepatitis C Antibodies D019698:Hepatitis C, Chronic D006801:Humans D007372:Interferons D007378:Interleukins D008103:Liver Cirrhosis D008297:Male D008875:Middle Aged D012367:RNA, Viral D019562:Viral Load
Asia hepatitis C virus fibrosis HIV chronic infection