Care of hepatitis C virus infection in human immunodeficiency virus-infected patients: modifications in three consecutive large surveys between 2004 and 2009.
OBJECTIVE
To analyze the care of HCV infection in HIV-HCV coinfected patients and its progression between 2004 and 2009.


METHODS
Three hundred eighty HIV-HCV coinfected patients were prospectively included from November 22 to 29, 2004 (2004 survey), 416 patients from April 3 to 10, 2006 (2006 survey), and 419 patients from June 15 to 22, 2009 (2009 survey).


RESULTS
The rate of liver biopsy decreased (14% vs. 38% vs. 56%), while the use of non-invasive liver damage tests increased (47% vs. 24% vs. ND) in the 2009, 2006, and 2004 surveys, respectively. The rate of patients that had never been treated for HCV infection progressively decreased in the 2009, 2006, and 2004 surveys (37%, 42%, and 54%). The main reasons for HCV non-treatment changed as HCV treatment was deemed less questionable and the lack of liver biopsy became a very rare reason (6%, 18%, and 34%). Among patients treated for HCV infection, the rate of sustained virological response increased (49%, 29%, and 29%). The main factors independently associated with HCV treatment were a liver fibrosis score > or =F2 (odds ratio=3.5; 95% CI 2.1-5.7), a liver biopsy activity grade > or =A2 (2.7; 1.4-5.3), a CD4 cell count > or =350 ml (2.7; 1.6-4.4), European origin (2.1; 1.3-3.4), daily alcohol consumption<30 g (2.1; 1.2-3.8), and male gender (2.0; 1.2-3.3).


CONCLUSIONS
Compared to the 2004 and 2006 surveys, the 2009 coinfected patients had liver damage assessment more frequently, more patients had received HCV treatment and more patients had achieved a sustained virological response.
Cacoub
Patrice
P
Université Pierre et Marie Curie-Paris6, CNRS, UMR 7211, France. patrice.cacoub@psl.aphp.fr
Halfon
Philippe
P
Rosenthal
Eric
E
Bailly
François
F
Sadr
Firouze Bani
FB
Benhamou
Yves
Y
Chevaliez
Stéphane
S
Pawlotsky
Jean Michel
JM
Piroth
Lionel
L
Yazdanpanah
Yazdan
Y
Pol
Stanislas
S
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001706:Biopsy; D015897:Comorbidity; D005260:Female; D005602:France; D015658:HIV Infections / Q000097:blood / Q000453:epidemiology / Q000628:therapy*; D015497:HIV-1; D006306:Health Surveys; D016174:Hepacivirus; D006526:Hepatitis C / Q000097:blood / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D008099:Liver / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D010346:Patient Care Management / Q000639:trends*; D011446:Prospective Studies; D012189:Retrospective Studies; D019562:Viral Load
D000998:Antiviral Agents