title: Characteristics and treatment outcomes among HIV-infected individuals in the Australian Trial in Acute Hepatitis C.
abstract: BACKGROUND
  The Australian Trial in Acute Hepatitis C (ATAHC) is a National Institutes of Health-funded prospective cohort study of the natural history and efficacy of treatment in individuals with recently acquired hepatitis C. Enrollment is open to both human immunodeficiency virus (HIV)-infected and -uninfected individuals. The aim of this article was to evaluate characteristics and virological outcomes among HIV-infected individuals enrolled in ATAHC.
  
  
  METHODS
  Eligibility criteria included the first positive result of testing for anti-hepatitis C virus (HCV) antibody within 6 months and either clinical hepatitis diagnosed within the past 12 months or documented anti-HCV seroconversion within the past 24 months.
  
  
  RESULTS
  Of the initial 103 patients enrolled, 27 (26%) were HIV infected. HIV-infected patients were more likely to be older, to have HCV genotype 1 infection and high levels of HCV RNA at baseline than were HCV-monoinfected patients. Sexual acquisition accounted for the majority (56%) of HCV infections among HIV-infected patients, compared with only 8% of HCV-monoinfected patients. The median duration from estimated HCV infection to treatment was 30 weeks. Treatment with 24 weeks of pegylated interferon and ribavirin resulted in rates of undetectability of HCV RNA of 95%, 90%, and 80% at weeks 12, 24, and 48, respectively. Undetectability at week 4 was achieved in 44% of patients and yielded positive and negative predictive values for sustained virological response of 100% and 33%, respectively.
  
  
  CONCLUSIONS
  Significant differences were demonstrated between HIV-infected and HIV-uninfected individuals enrolled in ATAHC. Treatment responses among HIV-infected individuals with both acute and early chronic infection are encouraging and support regular HCV screening of high-risk individuals and early treatment for recently acquired HCV infection.
authors.affiliation: National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, Australia. gmatthews@nchecr.unsw.edu.au
authors.forename: G V
authors.initials: GV
authors.lastname: Matthews
authors.forename: M
authors.initials: M
authors.lastname: Hellard
authors.forename: P
authors.initials: P
authors.lastname: Haber
authors.forename: B
authors.initials: B
authors.lastname: Yeung
authors.forename: P
authors.initials: P
authors.lastname: Marks
authors.forename: D
authors.initials: D
authors.lastname: Baker
authors.forename: G
authors.initials: G
authors.lastname: McCaughan
authors.forename: J
authors.initials: J
authors.lastname: Sasadeusz
authors.forename: P
authors.initials: P
authors.lastname: White
authors.forename: W
authors.initials: W
authors.lastname: Rawlinson
authors.forename: A
authors.initials: A
authors.lastname: Lloyd
authors.forename: J
authors.initials: J
authors.lastname: Kaldor
authors.forename: G J
authors.initials: GJ
authors.lastname: Dore
mesh_terms: D000328:Adult; D000367:Age Factors; D000998:Antiviral Agents / Q000627:therapeutic use; D001315:Australia; D015331:Cohort Studies; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000150:complications*; D016174:Hepacivirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D006526:Hepatitis C / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D012254:Ribavirin / Q000627:therapeutic use; D012307:Risk Factors; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D012367:RNA, Viral; D012254:Ribavirin; D007372:Interferons