title: Chronic hepatitis C infection and liver disease in HIV-coinfected patients in Asia.
abstract: Data on markers of hepatitis C virus (HCV) disease in HIV-HCV-coinfected patients in resource-limited settings are scarce. We assessed HCV RNA, HCV genotype (GT), IL28B GT and liver fibrosis (FibroScan®) in 480 HIV-infected patients with positive HCV antibody in four HIV treatment centres in South-East Asia. We enrolled 165 (34.4%) patients in Jakarta, 158 (32.9%) in Bangkok, 110 (22.9%) in Hanoi and 47 (9.8%) in Kuala Lumpur. Overall, 426 (88.8%) were male, the median (IQR) age was 38.1 (34.7-42.5) years, 365 (76.0%) reported HCV exposure through injecting drug use, and 453 (94.4%) were on combination antiretroviral therapy. The median (IQR) CD4 count was 446 (325-614) cells/mm3and 208 (94.1%) of 221 patients tested had HIV-1 RNA <400 copies/mL. A total of 412 (85.8%) had detectable HCV RNA, at a median (IQR) of 6.2 (5.4-6.6) log10IU/mL. Among 380 patients with HCV GT, 223 (58.7%) had GT1, 97 (25.5%) had GT3, 43 (11.3%) had GT6, eight (2.1%) had GT4, two (0.5%) had GT2, and seven (1.8%) had indeterminate GT. Of 222 patients with IL28B testing, 189 (85.1%) had rs12979860 CC genotype, and 199 (89.6%) had rs8099917 TT genotype. Of 380 patients with FibroScan®, 143 (37.6%) had no/mild liver fibrosis (F0-F1), 83 (21.8%) had moderate fibrosis (F2), 74 (19.5%) had severe fibrosis (F3), and 79 (20.8%) had cirrhosis (F4). One patient (0.3%) had FibroScan®failure. In conclusion, a high proportion of HIV-HCV-coinfected patients had chronic HCV infection. HCV GT1 was predominant, and 62% of patients had liver disease warranting prompt treatment (≥F2).
authors.affiliation: TREAT Asia, amfAR - The Foundation for AIDS Research, Bangkok, Thailand.
authors.forename: N
authors.initials: N
authors.lastname: Durier
authors.affiliation: Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.|Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
authors.forename: E
authors.initials: E
authors.lastname: Yunihastuti
authors.affiliation: HIVNAT, the Thai Red Cross AIDS Research Centre, Bangkok, Thailand.|Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors.forename: K
authors.initials: K
authors.lastname: Ruxrungtham
authors.affiliation: National Hospital of Tropical Diseases, Hanoi, Vietnam.
authors.forename: N V
authors.initials: NV
authors.lastname: Kinh
authors.affiliation: University of Malaya Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: A
authors.initials: A
authors.lastname: Kamarulzaman
authors.affiliation: The Kirby Institute, UNSW Australia, Sydney, NSW, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Boettiger
authors.affiliation: Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.|Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
authors.forename: A
authors.initials: A
authors.lastname: Widhani
authors.affiliation: HIVNAT, the Thai Red Cross AIDS Research Centre, Bangkok, Thailand.|Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors.forename: A
authors.initials: A
authors.lastname: Avihingsanon
authors.affiliation: National Hospital of Tropical Diseases, Hanoi, Vietnam.
authors.forename: B V
authors.initials: BV
authors.lastname: Huy
authors.affiliation: University of Malaya Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: S F B
authors.initials: SF
authors.lastname: Syed Omar
authors.affiliation: Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.|Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
authors.forename: A
authors.initials: A
authors.lastname: Sanityoso
authors.affiliation: Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors.forename: S
authors.initials: S
authors.lastname: Chittmittrapap
authors.affiliation: National Hospital of Tropical Diseases, Hanoi, Vietnam.
authors.forename: N T H
authors.initials: NT
authors.lastname: Dung
authors.affiliation: Faculty of Medicine, Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: V
authors.initials: V
authors.lastname: Pillai
authors.affiliation: TREAT Asia, amfAR - The Foundation for AIDS Research, Bangkok, Thailand.
authors.forename: T
authors.initials: T
authors.lastname: Suwan-Ampai
authors.affiliation: The Kirby Institute, UNSW Australia, Sydney, NSW, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Law
authors.affiliation: TREAT Asia, amfAR - The Foundation for AIDS Research, Bangkok, Thailand.
authors.forename: A H
authors.initials: AH
authors.lastname: Sohn
authors.affiliation: The Kirby Institute, UNSW Australia, Sydney, NSW, Australia.
authors.forename: G
authors.initials: G
authors.lastname: Matthews
mesh_terms: D000328:Adult; D000483:Alleles; D001210:Asia, Southeastern / Q000453:epidemiology; D018791:CD4 Lymphocyte Count; D060085:Coinfection / Q000150:complications* / Q000453:epidemiology / Q000473:pathology* / Q000821:virology; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D016174:Hepacivirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D018937:Hepatitis C Antibodies / Q000097:blood; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000453:epidemiology / Q000473:pathology* / Q000821:virology; D006801:Humans; D007372:Interferons; D007378:Interleukins / Q000235:genetics; D008103:Liver Cirrhosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D019562:Viral Load; D000095022:Interferon Lambda
chemical_list: D018937:Hepatitis C Antibodies; D007372:Interferons; D007378:Interleukins; D012367:RNA, Viral; C000624353:interferon-lambda, human; D000095022:Interferon Lambda
keywords: 
  HIV
  ; Asia; chronic infection; fibrosis; hepatitis C virus