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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

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HCV genotype and HBV co-infection associate with HCV clearance in HIV-positive subjects

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  1. 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

  2. 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

  3. HCV prevalence in people with HIV (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.

  4. Background • 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.

  5. HIV-HCV co-infection prevalence among IDUs in China 0 Xinjiang (36.2%) Yunnan (46.3%) Myanmar Vietnam Laos Thailand

  6. Study Objectives • 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.

  7. HIV-positive IDUs were recruitedin 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)

  8. Recruitment of HIV/HCV co-infected patients 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

  9. Demographic characteristics

  10. 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 +

  11. Univariate analysis of correlates of HCV clearance

  12. Multivariate logistic regression model for HCV clearance The model was adjusted for age and gender

  13. Clinical features of 231 HIV-infected patients with detectable HCV genotypes

  14. The appearance rate of different HCV genotype among HBV uninfected / chronic infected subjects

  15. Conclusions • 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.

  16. Acknowledgements 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).

  17. HCV genotype 1 infection stratified by CD4 counts

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