Chronic hepatitis C virus infection and subsequent HIV viral load among women with HIV initiating antiretroviral therapy
Year: 2018
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: One in four persons living with HIV is coinfected with hepatitis C virus (HCV). Biological and behavioral mechanisms may increase HIV viral load among coinfected persons. Therefore, we estimated the longitudinal effect of chronic HCV on HIV suppression after ART initiation among women with HIV (WWH). DESIGN: HIV RNA was measured every 6 months among 441 WWH in the Women's Interagency HIV Study who initiated ART from 2000 to 2015. METHODS: Log-binomial regression models were used to compare the proportion of study visits with detectable HIV RNA between women with and without chronic HCV. Robust sandwich variance estimators accounted for within-person correlation induced by repeated HIV RNA measurements during follow-up. We controlled for confounding and selection bias (because of loss to follow-up and death) using inverse probability-of-exposure-and-censoring weights. RESULTS: One hundred and fourteen women (25%) had chronic HCV before ART initiation. Overall, the proportion of visits with detectable HIV RNA was similar among women with and without chronic HCV [relative risk (RR) 1.19 (95% CI 0.72, 1.95)]. Six months after ART initiation, the proportion of visits with detectable HIV RNA among women with chronic HCV was 1.88 (95% CI 1.41-2.51) times that among women without HCV, at 2 years, the ratio was 1.60 (95% CI 1.17-2.19), and by 6 years there was no difference (1.03; 95% CI 0.60-1.79). CONCLUSION: Chronic HCV may negatively impact early HIV viral response to ART. These findings reaffirm the need to test persons with HIV for HCV infection, and increase engagement in HIV care and access to HCV treatment among persons with HIV/HCV coinfection.
Source: AIDS
Authors: Sarah J. Willis, Stephen R. Cole, Daniel Westreich, Andrew Edmonds, Christopher B. Hurt, Svenja Albrecht, Kathryn Anastos, Michael Augenbraun, Margaret Fischl, Audrey L. French, Aley G. Kalapila, Roksana Karim, Marion G. Peters, Michael Plankey, Eric C. Seaberg, Phyllis C. Tien, Adaora A. Adimora
Institutions: University of North Carolina at Chapel Hill, University of Mississippi Medical Center, Albert Einstein College of Medicine, Montefiore Medical Center, SUNY Downstate Health Sciences University, University of Miami, John H. Stroger, Jr. Hospital of Cook County, Emory University, University of Southern California, University of California, San Francisco, Georgetown University Medical Center, Johns Hopkins University
Language: English
Topic: Hepatitis C virus research
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: National Institutes of Health, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Allergy and Infectious Diseases, National Center for Advancing Translational Sciences, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: Emory R38 Research Training Program, Emory WIHS CRS - Longitudinal Cohort, The Connie Wofsy Women's HIV Study, Brooklyn Women's Interagency HIV Study (WIHS) V, Miami Womens Interagency HIV Study WIHS, WIHS Data Management and Analysis Center (WDMAC), Southern California Women's Interagency HIV Study Consortium, Chicago WIHS Consortium V (CWC), Washington Women's Interagency HIV/AIDS Study, Atlanta Clinical and Translational Science Institute (ACTSI) Renewal, University of North Carolina Womens Interagency HIV Study UNC WIHS, Women's Interagency HIV Study (WIHS-V), UAB-MISS WIHS Cohort, MACS/WIHS -CCS, Emory Specialized Center of Research Excellence (SCORE) on Sex Differences, UNC MACS/WIHS Combined Cohort Study Clinical Research Site, The University of North Carolina Center for AIDS Research, Georgia Clinical & Translational Science Alliance (Georgia CTSA), UAB-MISS MACS/WIHS Combined Cohort Study
OpenAlex ID: W2783154257