title: Burden of HIV and hepatitis C co-infection: the changing epidemiology of hepatitis C in HIV-infected patients in France.
abstract: OBJECTIVE
  To better evaluate the HIV-HCV co-infection burden in the context of new effective HCV treatment.
  
  
  METHODS
  We reviewed all the epidemiological data available on HCV-related disease in HIV-infected patients in France. Sources of data have been selected using the following criteria: (i) prospective cohorts or cross-sectional surveys; (ii) conducted at a national level; (iii) in the HIV-infected population; (iv) able to identify HCV co-infection and chronic active hepatitis C (HCV RNA positive); and (v) conducted during the period 2003-2012.
  
  
  RESULTS
  The overall prevalence of HIV-HCV co-infection has decreased from 22-24% to 16-18%. This prevalence decreased from 93% to 87% among injecting drug users while it increased from 4% to 6% among men who have sex with men. The characteristics of patients have changed: decrease in the proportion of patients with chronic active hepatitis C (HCV RNA positive) from 77% to 63% and in the genotypes 2 and 3 HCV infection; increase in the proportion of HCV genotype 1 (from 45-50% to 58%) and genotype 4 (from 15% to 22%). The proportion of patients treated with highly active antiretroviral therapy increased from 76% to 95%, with higher rates of undetectable HIV viral load (47% in 2004 vs. 85% in 2012).
  
  
  CONCLUSIONS
  The decreasing prevalence and the change in patients profile in HIV-HCV co-infection underline the importance of continuing efforts to educate physicians and patients. This should increase the benefit of viral risk reduction policies and increase the access of co-infected patients to HCV treatment.
authors.affiliation: Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Sorbonne Universités, UMR 7211, UPMC Univ Paris 06, Paris, F-75005, France; INSERM, UMR_S 959, Paris, F-75013, France; CNRS, FRE3632, Paris, F-75005, France; Department of Internal Medicine and Clinical Immunology, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, F-75013, France.
authors.forename: Patrice
authors.initials: P
authors.lastname: Cacoub
authors.forename: François
authors.initials: F
authors.lastname: Dabis
authors.forename: Dominique
authors.initials: D
authors.lastname: Costagliola
authors.forename: Kayigan
authors.initials: K
authors.lastname: Almeida
authors.forename: France
authors.initials: F
authors.lastname: Lert
authors.forename: Lionel
authors.initials: L
authors.lastname: Piroth
authors.forename: Caroline
authors.initials: C
authors.lastname: Semaille
mesh_terms: D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data; D060085:Coinfection / Q000453:epidemiology* / Q000266:history; D055030:Drug Users / Q000706:statistics & numerical data; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology*; D006526:Hepatitis C / Q000453:epidemiology*; D049674:History, 21st Century; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D015995:Prevalence
keywords: HCV; HIV; epidemiology