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HIV and hepatitis C coinfection within the CAESAR study.
1National Centre in HIV Epidemiology and Clinical Research (NCHECR), The University of New South Wales, Level 2, 376 Victoria Street, Darlinghurst, Sydney 2010, Australia.
HIV Medicine
|May 14, 2004
Summary
People with HIV infection have a high risk of hepatitis C virus (HCV) coinfection, especially those with a history of injecting drug use (IDU). Early HCV testing is crucial for this population to manage liver disease.
Area of Science:
- Infectious Diseases
- Hepatology
- Public Health
Background:
- Declining AIDS-related opportunistic diseases shift focus to comorbidities like chronic liver disease in people with HIV.
- Increased risk of hepatitis C virus (HCV)-related advanced liver disease in people with HIV necessitates early HCV diagnosis.
Purpose of the Study:
- To assess HCV prevalence and predictors of HIV/HCV coinfection in the CAESAR study cohort.
- To examine the impact of HCV on HIV disease progression.
Main Methods:
- Retrospective analysis of 1649 participants in the multinational CAESAR study.
- Anti-HCV antibody testing was performed.
- Analysis included HIV exposure category, alanine aminotransferase (ALT) levels, country, ethnicity, and HIV disease stage.
Main Results:
- Overall HIV/HCV coinfection prevalence was 16.1%, with significant geographical variation (1.9% in South Africa to 48.6% in Italy).
- Injecting drug use (IDU) was the strongest predictor (OR 365), followed by transfusion/blood products (OR 32.2).
- HIV disease progression was similar in HIV monoinfected and HIV/HCV coinfected patients.
Conclusions:
- People with HIV and a history of IDU or elevated liver function tests (ALT ≥ 40 U/L) should be prioritized for HCV testing.
- Low HCV prevalence among homosexual men without IDU history suggests limited sexual transmission efficiency.