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HIGH PREVALENCE OF HEPATITIS C CO-INFECTION AND ITS ASSOCIATION WITH SECOND-LINE THERAPY OUTCOMES AMONG HIV/AIDS PATIENTS IN HANOI
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Abstract
Introduction: This study examines the prevalence of Hepatitis C (HCV) co-infection and its association with treatment outcomes among HIV/AIDS patients taking second-line therapy at Bach Mai Hospital and National Hospital for Tropical Diseases. Participants and Methods: We conducted a prospective cohort from 2009 to 2016 at two large HIV out-patient clinics at National Hospital for Tropical Diseases and Bach Mai Hospital. A total of 120 patients who failed first-line antiretroviral therapy (ART) and starting second-line at the study sites were enrolled to the study. We followed patients for at least 12 months. CD4 cell counts and viral load testing were performed at 6 months (M6) and 12 months (M12) of follow-up. We used t-test and chi-square test to compare the treatment outcomes between HCV-coinfected group and non-coinfected group at M6 and M12. Results: The overall prevalence of HCV co-infection among participants was 48.3%. At baseline, the proportion of patients at WHO clinical stage 3 or 4 was 38,3%. The median CD4 cell counts and viral load at baseline were 69 cells/cm3 (IQR: 33 – 197.5) and 27,200 copies/mL (IQR: 6.430 – 104.000). At 6 and 12 months of treatment with second-line regimens, the median of CD4 counts was reported as 168 cells/mm3 (IQR: 108.5 – 259) and 240.5 cells/mm3 (150 – 347), respectively. Compare between HCV-coinfected and non-coinfected group, the patients with HCV negative found to be have better responses than those who have positive (median at M6 was 177 cells/cm3 vs. 152 cells/cm3, p=0.05; and at M12 was 253 cells/cm3 vs. 230 cells/cm3, p=0.07). The proportion of patients have viral suppression (SVR) at M6 and M12 in HCV co-infected group were 37.1% and 62.9%, which slightly lower than non-coinfected group (SVR at M6 was 50%, p=0.15; and at M12 was 69.0%, p=0.48). Conclusion: Our study found that among a large sample of HIV/AIDS patients taking second-line therapy in Hanoi, patients with non-coinfected with HCV have better CD4 counts outcomes than patients with HCV-coinfected. However, the SVR between two groups showed no significant different.
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Keywords
HIV/AIDS; HCV co-infection, second-line, antiretroviral therapy, ART.
References
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