title: Factors associated with liver biopsy performance in HCV-HIV coinfected injecting drug users with HCV viremia: results from a five-year longitudinal assessment.
abstract: The last international consensus conference about hepatitis C virus (HCV) treatment emphasized the importance of treatment for persons coinfected with HCV and human immunodeficiency virus (HIV). As liver biopsy precedes treatment, we aimed to identify factors associated with the performance of liver biopsy among HIV-HCV coinfected drug users during a 5-year follow-up to study their access to HCV treatment. Of the 296 patients followed in the HIV hospital departments of Nice and Marseilles and with retrievable records about HCV diagnosis and care, 166 were eligible for analysis having had detectable HCV RNA at least once during the study period. Overall, 45.2% of patients underwent liver biopsy during follow-up. Using proportional hazard models, predictors of having had a liver biopsy were high social support, complete abstinence from drug injection, and lack of immunosuppression as well as male gender, no history of multiple incarcerations, more recent onset of drug use, and an increase of liver enzyme levels. These results suggest that specific efforts should be devoted to HIV-HCV coinfected drug users to assist with stabilizing these patients to optimize their access to HCV care whenever possible.
authors.affiliation: Regional Center for Disease Control (ORS PACA) of Southeastern France, 23 rue Stanislas Torrents, 13006 Marseille, France. rey@marseille.inserm.fr
authors.forename: Dominique
authors.initials: D
authors.lastname: Rey
authors.forename: Maria-Patrizia
authors.initials: MP
authors.lastname: Carrieri
authors.forename: Bruno
authors.initials: B
authors.lastname: Spire
authors.forename: Sandrine
authors.initials: S
authors.lastname: Loubière
authors.forename: Pierre
authors.initials: P
authors.lastname: Dellamonica
authors.forename: Hervé
authors.initials: H
authors.lastname: Gallais
authors.forename: Gilles-Patrice
authors.initials: GP
authors.lastname: Cassuto
authors.forename: Jean-Albert
authors.initials: JA
authors.lastname: Gastaut
authors.forename: Yolande
authors.initials: Y
authors.lastname: Obadia
mesh_terms: D000410:Alanine Transaminase / Q000032:analysis; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D001219:Aspartate Aminotransferases / Q000032:analysis; D001706:Biopsy / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D019983:Guideline Adherence; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D006297:Health Services Accessibility; D016174:Hepacivirus / Q000201:enzymology / Q000235:genetics; D006526:Hepatitis C / Q000150:complications / Q000473:pathology* / Q000628:therapy; D006748:Hospital Departments; D006801:Humans; D007124:Immunoenzyme Techniques / Q000706:statistics & numerical data; D008099:Liver / Q000201:enzymology / Q000473:pathology*; D008137:Longitudinal Studies; D008297:Male; D016016:Proportional Hazards Models; D012737:Sex Factors; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000821:virology
chemical_list: D044966:Anti-Retroviral Agents; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase