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HCV genotype and HBV co-infection associate with HCV clearance in HIV-positive subjects . Yuan Dong , Chao Qiu, Xueshan Xia, Jing Wang, Haiyan Zhang, Yongheng Wang, Xiaoyan Zhang, Jianqing Xu

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Hcv genotype and hbv co infection associate with hcv clearance in hiv positive subjects
HCV genotype and HBV co-infection associate with HCV clearance in HIV-positive subjects

Yuan Dong, Chao Qiu, Xueshan Xia, Jing Wang, Haiyan Zhang, Yongheng Wang, Xiaoyan Zhang, Jianqing Xu

Shanghai Public Health Clinical Center and Institutes of Biomedical Sciences, Fudan University, Shanghai, China


Chronic liver disease is increasingly contributing to morbidity and mortality among people with HIV, particularly HCV-related liver disease

Dominique Salmon-Ceron,et al. Journal of Hepatology, 2009, 50: 736-745

E. Rosenthal, et al. Journal of Viral Hepatitis, 2007, 14: 184-188


HCV prevalence in people with HIV morbidity and mortality among people with HIV, particularly HCV-related liver disease

(TAHOD, TREAT Asia HIV Observational Database; &The Swiss HIV Cohort study)

Jialun Zhou, et al, Journal of Gastroenterology and Hepatology, 2007, 22: 1510-1518

Greub G, et al. Lancet. 2000 Nov 25;356(9244):1800-5.


Background
Background morbidity and mortality among people with HIV, particularly HCV-related liver disease

  • It remains unknown the associations of HCV clearance in HIV-positive Chinese IDUs.

  • Less is known about whether and how HCV genotypes affect its clearance.


HIV-HCV co-infection prevalence among IDUs in China morbidity and mortality among people with HIV, particularly HCV-related liver disease

0

Xinjiang

(36.2%)

Yunnan

(46.3%)

Myanmar

Vietnam

Laos

Thailand


Study objectives
Study Objectives morbidity and mortality among people with HIV, particularly HCV-related liver disease

  • To determine the prevalence of HCV infection, spontaneous clearance and genotype distribution among HIV-positive IDUs from Yunnan, a region with the highest HIV-HCV co-infection prevalence in China.

  • To search for factors that may affect the clearance of HCV and whether HCV genotypes could exert different influences on those factors.


HIV-positive IDUs were morbidity and mortality among people with HIV, particularly HCV-related liver diseaserecruitedin Yunnan Province

( Dali CDC, Compulsory detoxification, Labor camp )

Interview

Sociodemographic information, high-risk behaviors

and history of HIV-infection and medication

Blood collection

CD4 T cell count(FACSAria flow cytometry; BD Bioscience),ALT,TB

Anti-HCV Ab(ELISA; Kehua Company)

HBsAb, HBsAg, HBeAg, HBeAb, HBcAb(ELISA; Wantai Company)

HCV viral load(Realtime-PCR; PG Biotech Company)

HCV genotyping(5’NCR/ NS5B/ E1–E2; ABI Prism 3100 genetic analyzer)

Data analysis SPSS software (version 17.0)


Recruitment of hiv hcv co infected patients
Recruitment of HIV/HCV co-infected patients morbidity and mortality among people with HIV, particularly HCV-related liver disease

529 HIV infected patients

47 HCV uninfected patients

24 newly infected HCV patients

1 had invalid data

457 HCV infected patients

98 HCV cleared patients

359 HCV chronic infected patients

31 HBV uninfected

43 resolved HBV

24 chronic HBV

144 HBV uninfected

187 resolved HBV

28 chronic HBV


Demographic characteristics
Demographic characteristics morbidity and mortality among people with HIV, particularly HCV-related liver disease


HCV prevalence, spontaneous clearance and genotype distribution

98/457(21.4)anti-HCV+ HIV+ subjects

were HCV RNA-

481/528(91.1%) HCV infected among HIV+

457/528 (86.6) anti-HCV+ among HIV +



Multivariate logistic regression model for HCV clearance distribution

The model was adjusted for age and gender



The appearance rate of different HCV genotype among detectable

HBV uninfected / chronic infected subjects


Conclusions
Conclusions detectable

  • The prevalence of HCV was 91.1% among HIV-infected IDUs, the spontaneous clearance rate was 21.4%.

  • Our results suggested that the reserved host immune function (high CD4+T counts) and HBV co-infection (chronic HBV) could improve HCV clearance in HIV-infected IDUs whereas the damage in liver (high level of ALT) was associated with the non-clearance of HCV.

  • We demonstrated that the clearance of different HCV genotypes might be facilitated by different factors. HBV chronic infection seemed to facilitate HCV genotype 3 clearance but not genotype 1 and 6.

  • Further cohort studies are needed to determine the influences of HCV genotypes and HBV co-infection on the HCV spontaneous clearance.


Acknowledgements detectable

We thank all the patients and investigators!

Chao Qiu , Fudan University

Xueshan Xia, Kunming University of Science and Technology

Jing Wang, Fudan University

Haiyan Zhang, Dali CDC

Yongheng Wang, Dali CDC

Guomei Sun, Fudan University

Xiaoyan Zhang, Fudan University

Jianqing Xu, Fudan University

This work was supported by 973 program (2012CB519005) and National Grand Program on Key Infectious Disease Control (2012ZX10001-006).



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