Liver-related death among HIV/hepatitis C virus-co-infected individuals: Implications for the era of directly acting antivirals

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064211%3A_____%2F15%3A%230000472" target="_blank" >RIV/00064211:_____/15:#0000472 - isvavai.cz</a>

Výsledek na webu

<a href="http://dx.doi.org/10.1097/QAD.0000000000000674" target="_blank" >http://dx.doi.org/10.1097/QAD.0000000000000674</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1097/QAD.0000000000000674" target="_blank" >10.1097/QAD.0000000000000674</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Liver-related death among HIV/hepatitis C virus-co-infected individuals: Implications for the era of directly acting antivirals

Popis výsledku v původním jazyce

Background: Potent, less toxic, directly acting antivirals (DAAs) for treatment of hepatitis C virus (HCV) infection promise to improve HCV cure rates among HIV/ HCV-co-infected individuals. However, the costs of treatment will necessitate prioritization of those at greatest risk of liver-related death (LRD) for therapy. This study aims to provide guidance on who should be prioritized for DAA treatment. Methods: Three thousand, nine hundred and forty-one HCV antibody-positive PSHREG and FIB-4 are names not acronyms (EuroSIDA) patients with follow-up after 1 January 2000 were included, with causes of death classified using Coding causes of Death in HIV (CoDe) methodology. Crude death rates, competing-risks Cox proportional- hazards models and cumulative incidence functions were used to describe factors associated with LRD. Results: LRD accounted for 145 of 670 (21.6%) deaths in the study population. LRD rates peaked in those aged 35'45 years, and occurred almost exclusively in those with at least F2 fibrosis at baseline. In adjustedCoxmodels, risk factors for LRDincluded F4 or F2/F3 fibrosis [sub-distribution hazard ratio (sHR) 6.3, 95%confidence interval (CI)4.1'9.6; andsHR2.5, 95%CI 1.5'4.2 vs. F0/F1, respectively), CD4 cell count (sHR 0.83, 95%CI 0.73'0.95 per doubling) and hepatitis B surface antigen-positive (sHR 2.2, 95% CI 1.3'3.5 vs. hepatitis B surface antigen-negative). The 5-year probability of LRD was low in those with F0/F1 fibrosis (sHR2.2%, 95%CI 1.7''2.9), but substantial in those withF2/F3 and F4 fibrosis (sHR 10.3%, 95% CI 7.6'13.5; and sHR 14.0%, 95% CI 10.3'18.3, respectively). Conclusion: Treatment with DAAs should be prioritized for those with at least F2 fibrosis. Early initiation of cART with the aim of avoiding low CD4 cell counts should be considered essential to decrease the risk of LRD and the need for HCV treatment.

Název v anglickém jazyce

Liver-related death among HIV/hepatitis C virus-co-infected individuals: Implications for the era of directly acting antivirals

Popis výsledku anglicky

Background: Potent, less toxic, directly acting antivirals (DAAs) for treatment of hepatitis C virus (HCV) infection promise to improve HCV cure rates among HIV/ HCV-co-infected individuals. However, the costs of treatment will necessitate prioritization of those at greatest risk of liver-related death (LRD) for therapy. This study aims to provide guidance on who should be prioritized for DAA treatment. Methods: Three thousand, nine hundred and forty-one HCV antibody-positive PSHREG and FIB-4 are names not acronyms (EuroSIDA) patients with follow-up after 1 January 2000 were included, with causes of death classified using Coding causes of Death in HIV (CoDe) methodology. Crude death rates, competing-risks Cox proportional- hazards models and cumulative incidence functions were used to describe factors associated with LRD. Results: LRD accounted for 145 of 670 (21.6%) deaths in the study population. LRD rates peaked in those aged 35'45 years, and occurred almost exclusively in those with at least F2 fibrosis at baseline. In adjustedCoxmodels, risk factors for LRDincluded F4 or F2/F3 fibrosis [sub-distribution hazard ratio (sHR) 6.3, 95%confidence interval (CI)4.1'9.6; andsHR2.5, 95%CI 1.5'4.2 vs. F0/F1, respectively), CD4 cell count (sHR 0.83, 95%CI 0.73'0.95 per doubling) and hepatitis B surface antigen-positive (sHR 2.2, 95% CI 1.3'3.5 vs. hepatitis B surface antigen-negative). The 5-year probability of LRD was low in those with F0/F1 fibrosis (sHR2.2%, 95%CI 1.7''2.9), but substantial in those withF2/F3 and F4 fibrosis (sHR 10.3%, 95% CI 7.6'13.5; and sHR 14.0%, 95% CI 10.3'18.3, respectively). Conclusion: Treatment with DAAs should be prioritized for those with at least F2 fibrosis. Early initiation of cART with the aim of avoiding low CD4 cell counts should be considered essential to decrease the risk of LRD and the need for HCV treatment.

Druh

J_x - Nezařazeno - Článek v odborném periodiku (Jimp, Jsc a Jost)

CEP obor

FN - Epidemiologie, infekční nemoci a klinická imunologie

OECD FORD obor

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Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2015

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

AIDS

ISSN

0269-9370

e-ISSN

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Svazek periodika

29

Číslo periodika v rámci svazku

10

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

11

Strana od-do

1206-1215

Kód UT WoS článku

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EID výsledku v databázi Scopus

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