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Burden of HIV and hepatitis C co‐infection: the changing epidemiology of hepatitis C in HIV ‐infected patients in France
Author(s) -
Cacoub Patrice,
Dabis François,
Costagliola Dominique,
Almeida Kayigan,
Lert France,
Piroth Lionel,
Semaille Caroline
Publication year - 2015
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.12639
Subject(s) - medicine , hepatitis c , epidemiology , viral load , context (archaeology) , population , hepatitis c virus , immunology , human immunodeficiency virus (hiv) , virology , environmental health , virus , biology , paleontology
Abstract Background & Aims 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). Conclusion 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.