The French national prospective cohort of patients co-infected with HIV and HCV (ANRS CO13 HEPAVIH): early findings, 2006-2010

Marc-Arthur Loko, Dominique Salmon, Patrizia Carrieri, Maria Winnock, Marion Mora, Laurence Merchadou, Stéphanie Gillet, Elodie Pambrun, Jean Delaune, Marc-Antoine Valantin, Isabelle Poizot-Martin, Didier Neau, Philippe Bonnard, Eric Rosenthal, Karl Barange, Philippe Morlat, Karine Lacombe, Anne Gervais, François Rouges, Alain Bicart See, Caroline Lascoux-Combe, Daniel Vittecoq, Cécile Goujard, Claudine Duvivier, Bruno Spire, Jacques Izopet, Philippe Sogni, Lawrence Serfaty, Yves Benhamou, Firouzé Bani-Sadr, François Dabis, ANRS CO 13 HEPAVIH Study Group, D Salmon, F Dabis, M Winnock, M A Loko, P Sogni, Y Benhamou, P Trimoulet, J Izopet, V Paradis, B Spire, P Carrieri, C Katlama, G Pialoux, M A Valantin, P Bonnard, I Poizot-Martin, B Marchou, E Rosenthal, A Bicart See, R Djebbar, A Gervais, C Lascoux-Combe, C Goujard, K Lacombe, C Duvivier, D Vittecoq, D Neau, P Morlat, F BaniSadr, L Meyer, F Boufassa, S Dominguez, B Autran, A M Roque, C Solas, H Fontaine, L Serfaty, G Chêne, D Costagliola, S Couffin-Cadiergues, D Salmon, P Sogni, B Terris, Z Makhlouf, G Dubost, F Tessier, L Gibault, F Beuvon, E Chambon, T Lazure, A Krivine, C Katlama, M A Valantin, S Dominguez, Y Benhamou, F Charlotte, S Fourati, I Poizot-Martin, O Zaegel, A Ménard, C Tamalet, G Pialoux, P Bonnard, F Bani-Sadr, P Callard, F Bendjaballah, H Assami, B Marchou, L Alric, K Barange, S Metivier, E Rosenthal, C Pradier, J Haudebourg, M C Saint-Paul, F Rouges, R Djebbar, M Ziol, Y Baazia, M Uzan, A Bicart-See, D Garipuy, F Nicot, P Yéni, A Gervais, H Adle-Biassette, D Séréni, C Lascoux Combe, P Bertheau, J Duclos, P Palmer, P M Girard, K Lacombe, P Campa, D Wendum, P Cervera, J Adam, N Harchi, J F Delfraissy, C Goujard, Y Quertainmont, C Pallier, D Vittecoq, O Lortholary, C Duvivier, S Boucly, D Neau, P Morlat, I Raymond, I Louis, P Bioulac-Sage, P Trimoulet, P Pinson, D Beniken, A-S Ritleng, A Fooladi, M Azar, P Honoré, S Breau, L Serini, M Mole, M Malet, C Bolliot, F Touam, S Mellul, G Alexandre, A Ganon, S Thirrée, S Gillet, J Delaune, L Dequae Merchadou, E Pambrun, A Frosch, J Cohen, J Cohen, P Kurkdji, M A Loko, M Winnock, Marc-Arthur Loko, Dominique Salmon, Patrizia Carrieri, Maria Winnock, Marion Mora, Laurence Merchadou, Stéphanie Gillet, Elodie Pambrun, Jean Delaune, Marc-Antoine Valantin, Isabelle Poizot-Martin, Didier Neau, Philippe Bonnard, Eric Rosenthal, Karl Barange, Philippe Morlat, Karine Lacombe, Anne Gervais, François Rouges, Alain Bicart See, Caroline Lascoux-Combe, Daniel Vittecoq, Cécile Goujard, Claudine Duvivier, Bruno Spire, Jacques Izopet, Philippe Sogni, Lawrence Serfaty, Yves Benhamou, Firouzé Bani-Sadr, François Dabis, ANRS CO 13 HEPAVIH Study Group, D Salmon, F Dabis, M Winnock, M A Loko, P Sogni, Y Benhamou, P Trimoulet, J Izopet, V Paradis, B Spire, P Carrieri, C Katlama, G Pialoux, M A Valantin, P Bonnard, I Poizot-Martin, B Marchou, E Rosenthal, A Bicart See, R Djebbar, A Gervais, C Lascoux-Combe, C Goujard, K Lacombe, C Duvivier, D Vittecoq, D Neau, P Morlat, F BaniSadr, L Meyer, F Boufassa, S Dominguez, B Autran, A M Roque, C Solas, H Fontaine, L Serfaty, G Chêne, D Costagliola, S Couffin-Cadiergues, D Salmon, P Sogni, B Terris, Z Makhlouf, G Dubost, F Tessier, L Gibault, F Beuvon, E Chambon, T Lazure, A Krivine, C Katlama, M A Valantin, S Dominguez, Y Benhamou, F Charlotte, S Fourati, I Poizot-Martin, O Zaegel, A Ménard, C Tamalet, G Pialoux, P Bonnard, F Bani-Sadr, P Callard, F Bendjaballah, H Assami, B Marchou, L Alric, K Barange, S Metivier, E Rosenthal, C Pradier, J Haudebourg, M C Saint-Paul, F Rouges, R Djebbar, M Ziol, Y Baazia, M Uzan, A Bicart-See, D Garipuy, F Nicot, P Yéni, A Gervais, H Adle-Biassette, D Séréni, C Lascoux Combe, P Bertheau, J Duclos, P Palmer, P M Girard, K Lacombe, P Campa, D Wendum, P Cervera, J Adam, N Harchi, J F Delfraissy, C Goujard, Y Quertainmont, C Pallier, D Vittecoq, O Lortholary, C Duvivier, S Boucly, D Neau, P Morlat, I Raymond, I Louis, P Bioulac-Sage, P Trimoulet, P Pinson, D Beniken, A-S Ritleng, A Fooladi, M Azar, P Honoré, S Breau, L Serini, M Mole, M Malet, C Bolliot, F Touam, S Mellul, G Alexandre, A Ganon, S Thirrée, S Gillet, J Delaune, L Dequae Merchadou, E Pambrun, A Frosch, J Cohen, J Cohen, P Kurkdji, M A Loko, M Winnock

Abstract

Background: In France, it is estimated that 24% of HIV-infected patients are also infected with HCV. Longitudinal studies addressing clinical and public health questions related to HIV-HCV co-infection (HIV-HCV clinical progression and its determinants including genetic dimension, patients' experience with these two diseases and their treatments) are limited. The ANRS CO 13 HEPAVIH cohort was set up to explore these critical questions.To describe the cohort aims and organization, monitoring and data collection procedures, baseline characteristics, as well as follow-up findings to date.

Methods: Inclusion criteria in the cohort were: age > 18 years, HIV-1 infection, chronic hepatitis C virus (HCV) infection or sustained response to HCV treatment. A standardized medical questionnaire collecting socio-demographic, clinical, biological, therapeutic, histological, ultrasound and endoscopic data is administered at enrollment, then every six months for cirrhotic patients or yearly for non-cirrhotic patients. Also, a self-administered questionnaire documenting socio-behavioral data and adherence to HIV and/or HCV treatments is administered at enrollment and yearly thereafter.

Results: A total of 1,175 patients were included from January 2006 to December 2008. Their median age at enrollment was 45 years and 70.2% were male. The median CD4 cell count was 442 (IQR: 304-633) cells/μl and HIV RNA plasma viral load was undetectable in 68.8%. Most participants (71.6%) were on HAART. Among the 1,048 HIV-HCV chronically co-infected patients, HCV genotype 1 was predominant (56%) and cirrhosis was present in 25%. As of January, 2010, after a median follow-up of 16.7 months (IQR: 11.3-25.3), 13 new cases of decompensated cirrhosis, nine hepatocellular carcinomas and 20 HCV-related deaths were reported, resulting in a cumulative HCV-related severe event rate of 1.9/100 person-years (95% CI: 1.3-2.5). The rate of HCV-related severe events was higher in cirrhotic patients and those with a low CD4 cells count, but did not differ according to sex, age, alcohol consumption, CDC clinical stage or HCV status.

Conclusion: The ANRS CO 13 HEPAVIH is a nation-wide cohort using a large network of HIV treatment, infectious diseases and internal medicine clinics in France, and thus is highly representative of the French population living with these two viruses and in care.

Figures

Figure 1
Figure 1
Algorithm for assessing cirrhosis, ANRS CO 13 HEPAVIH cohort of HIV-HCV co-infected patients.
Figure 2
Figure 2
Prevalence of liver fibrosis and its 95% confidence interval at baseline (+/- 1 year) in patients with concomitant results of liver biopsy, FibroScan™ and FibroTest™, and regardless of HCV status (N = 78), ANRS CO 13 HEPAVIH cohort of HIV-HCV co-infected patients, France, 2006-2008.
Figure 3
Figure 3
Probability of remaining free of HCV-related severe event*, according to cirrhosis status, ANRS CO 13 HEPAVIH cohort of HIV-HCV co-infected patients. Bars represent confidence intervals at 6, 12 and 18 months

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Source: PubMed

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