EVALUATION OF HIV-HCV CO-INFECTED SUBJECTS RECEIVING HCV TREATMENT AT THE OTTAWA HOSPITAL VIRAL HEPATITIS CLINIC

CL Cooper, A LaRoche, M Kane, GE Garber
Division of Infectious Diseases, The Ottawa Hospital, University of Ottawa

Introduction: The natural history of HCV, response to HCV antiviral therapy, and metabolic effects of HCV drug therapy in HIV-HCV co-infection remain unresolved.
Methods: Relevant demographic, laboratory, virologic, radiological, and pathology results of all HCV PCR positive subjects evaluated at The Ottawa Hospital Viral Hepatitis Clinic were entered into a database. Hepatic fibrosis rates were calculated, HCV treatment outcomes evaluated, and metabolic consequences of HCV therapy in HIV-HCV co-infected subjects assessed.
Results:

Fibrosis rate was more rapid in those consuming >50g alcohol per day (0.127 versus 0.097) and in males (0.125 versus 0.062, p=0.02), irrespective of HIV status. Fibrosis rate was less in HAART recipients (0.132 versus 0.191).

HIV virologic suppression was maintained while on interferon-based therapy. Glucose, cholesterol (total, HDL, LDL), and triglyceride levels were unchanged over the course of treatment, irrespective of HIV status.
Conclusions: In HIV-HCV co-infection, male sex and alcohol accelerate hepatic fibrosis. HAART may reduce the rate of hepatic fibrosis. Even with virologically active HAART, SVR is markedly decreased. Lipid and glucose levels are not markedly influenced by HCV antiviral therapy. Alternative HCV therapies, especially for those with HIV, are required.

NEXT ABSTRACT >