Chronic hepatitis C virus infection and subsequent HIV viral load among women with HIV initiating antiretroviral therapy

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 Carl Seaberg, Phyllis C. Tien, Adaora A. Adimora

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)653-661
Number of pages9
JournalAIDS
Volume32
Issue number5
DOIs
StatePublished - Mar 13 2018

Fingerprint

Chronic Hepatitis C
Virus Diseases
Viral Load
Hepacivirus
HIV
Therapeutics
RNA
Selection Bias
Statistical Models
Coinfection

Keywords

  • antiretroviral therapy
  • hepatitis C virus
  • hepatitis C virus coinfection
  • HIV infection
  • viral load
  • women

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

Willis, S. J., Cole, S. R., Westreich, D., Edmonds, A., Hurt, C. B., Albrecht, S., ... Adimora, A. A. (2018). Chronic hepatitis C virus infection and subsequent HIV viral load among women with HIV initiating antiretroviral therapy. AIDS, 32(5), 653-661. https://doi.org/10.1097/QAD.0000000000001745

Chronic hepatitis C virus infection and subsequent HIV viral load among women with HIV initiating antiretroviral therapy. / Willis, Sarah J.; Cole, Stephen R.; Westreich, Daniel; Edmonds, Andrew; Hurt, Christopher B.; Albrecht, Svenja; Anastos, Kathryn; Augenbraun, Michael; Fischl, Margaret; French, Audrey L.; Kalapila, Aley G.; Karim, Roksana; Peters, Marion G.; Plankey, Michael; Seaberg, Eric Carl; Tien, Phyllis C.; Adimora, Adaora A.

In: AIDS, Vol. 32, No. 5, 13.03.2018, p. 653-661.

Research output: Contribution to journalArticle

Willis, SJ, Cole, SR, Westreich, D, Edmonds, A, Hurt, CB, Albrecht, S, Anastos, K, Augenbraun, M, Fischl, M, French, AL, Kalapila, AG, Karim, R, Peters, MG, Plankey, M, Seaberg, EC, Tien, PC & Adimora, AA 2018, 'Chronic hepatitis C virus infection and subsequent HIV viral load among women with HIV initiating antiretroviral therapy', AIDS, vol. 32, no. 5, pp. 653-661. https://doi.org/10.1097/QAD.0000000000001745
Willis, Sarah J. ; Cole, Stephen R. ; Westreich, Daniel ; Edmonds, Andrew ; Hurt, Christopher B. ; Albrecht, Svenja ; Anastos, Kathryn ; Augenbraun, Michael ; Fischl, Margaret ; French, Audrey L. ; Kalapila, Aley G. ; Karim, Roksana ; Peters, Marion G. ; Plankey, Michael ; Seaberg, Eric Carl ; Tien, Phyllis C. ; Adimora, Adaora A. / Chronic hepatitis C virus infection and subsequent HIV viral load among women with HIV initiating antiretroviral therapy. In: AIDS. 2018 ; Vol. 32, No. 5. pp. 653-661.
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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.",
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AU - Willis, Sarah J.

AU - Cole, Stephen R.

AU - Westreich, Daniel

AU - Edmonds, Andrew

AU - Hurt, Christopher B.

AU - Albrecht, Svenja

AU - Anastos, Kathryn

AU - Augenbraun, Michael

AU - Fischl, Margaret

AU - French, Audrey L.

AU - Kalapila, Aley G.

AU - Karim, Roksana

AU - Peters, Marion G.

AU - Plankey, Michael

AU - Seaberg, Eric Carl

AU - Tien, Phyllis C.

AU - Adimora, Adaora A.

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N2 - 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.

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