• Biosensors
• Clinical approaches
• Hepatitis C virus (HCV)
• Nanomedicine

• Humans
• Biosensing Techniques/methods
• Hepacivirus/isolation & purification
• Hepacivirus/genetics
• Hepatitis C/diagnosis
• Nanotechnology/methods

• Disengagement
• HIV
• HIV-hepatitis C co-infection
• Hepatitis C
• Lost-to-follow-up
• Retention
• Scoping review

• Humans
• HIV Infections/drug therapy
• HIV Infections/psychology
• HIV Infections/complications
• Hepatitis C/drug therapy
• Hepatitis C/epidemiology
• Coinfection
• Patient Acceptance of Health Care/statistics & numerical data
• Patient Acceptance of Health Care/psychology

• Canadian Network on Hepatitis C (CanHepC) Canadian Network on Hepatitis C (CanHepC)

• DAA
• HIV/HCV coinfection
• comorbidities
• direct-acting antivirals
• mortality
• non-AIDS-related events

• Not applicable Gilead Sciences (Spain)

• Antiviral Agents/therapeutic use
• COVID-19/epidemiology
• Germany/epidemiology
• HIV Infections/drug therapy
• HIV Infections/epidemiology
• Hepacivirus
• Hepatitis C/drug therapy
• Hepatitis C/epidemiology
• Hepatitis C, Chronic/drug therapy
• Homosexuality, Male
• Humans
• Incidence
• Male
• Pandemics
• Prospective Studies
• Sexual and Gender Minorities

• R01 AI135992 NIAID NIH HHS
• UL1 TR001442 NCATS NIH HHS
• P30 AI036214 NIAID NIH HHS
• T32 DA023356 NIDA NIH HHS
• D43 TW009343 FIC NIH HHS

• DAAs
• HCV
• HIV
• barriers, coinfection

• Asia
• HCV
• HCV/HIV co-infection
• HIV
• genotype
• hepatitis C

• Hepacivirus/genetics
• Hepatitis C/diagnosis
• Humans
• Mass Screening
• Microfluidics

• DAAs-based therapy
• HIV/HCV coinfection
• T-cell homeostasis disturbances
• immune restoration
• liver stiffness

• DAAs
• HCV eradication
• HIV/HCV coinfection
• endothelial activation
• liver stiffness
• systemic inflammation

• HCV
• elimination
• hepatitis C virus
• modeling
• prevention

The advent of direct-acting antiviral (DAA) therapies has dramatically transformed HCV treatment, with most recent trials demonstrating high efficacy rates (>90%) across all genotypes and special populations, including patients with HIV/HCV coinfection. The efficacy rates of HCV treatment are nearly identical between patients with HCV monofection and patients with HIV/HCV coinfection; however, there are limited studies to compare real-world efficacy with efficacy observed in clinical trials. Using a database from HIV clinics across the United States (US), we identified 432 patients with HIV/HCV coinfection who completed DAA therapy from January 1, 2014 to March 31, 2017 and were assessed for efficacy. Efficacy was evaluated as sustained virologic response (SVR) 12 weeks after DAA completion; furthermore, factors associated with achieving SVR12 were identified. In this analysis, we found DAA therapies to be effective, with 94% of the patients achieving SVR12 and 6% experiencing virologic failure. Baseline variables, including older age, HCV viral load <800K IU/ML, FIB-4 score <1.45, absence of depression, diabetes, substance abuse, and use of DAA regimens without ribavirin were significant predictors of achieving SVR12. Patients with fewer comorbidities, better liver health, and lower HCV viral loads at baseline were more likely to achieve treatment success. Our results were consistent with other real-world studies, supporting the use of HCV therapy in HIV/HCV coinfected patients.

Steatosis contributes to liver fibrosis in hepatitis C virus (HCV) and human immunodeficiency virus (HIV)/HCV coinfection. Liver biopsy (LB) is the reference standard for grading steatosis and staging fibrosis, yet recent advances in noninvasive modalities have largely supplanted LB, which may limit recognition of steatosis. We evaluated steatosis rates by LB and transient elastography (TE) with controlled attenuation parameter (CAP) among HCV-infected and HIV/HCV-coinfected patients in a US clinic.

Patients with chronic HCV infection during pretreatment evaluation by LB (n = 421; December 2001 through May 2014) and TE with CAP (n = 1157; May 2016 through May 2017) were included. Fibrosis and steatosis rates by LB and TE with CAP were stratified by HCV versus HIV/HCV coinfection status.

Steatosis was not reported in 26.1% of LBs. Moderate to severe steatosis (grade ≥S2) was detected more often with CAP than with LB (in 24.0% vs 11.4% of patients, respectively). Median CAP values were higher in patients with HCV monoinfection than in those with coinfection (230 vs 215.5 dB/m, respectively; P < .001). With TE, the rate of advanced fibrosis (values F3–F4) was higher in HCV monoinfection than in coinfection (25.9% vs 14.8%, respectively; P <.001). With both LB and TE, advanced fibrosis (F3–F4) was significantly associated with moderate to severe steatosis (S2–S3) in HCV monoinfection compared with HIV/HCV coinfection (33.3% vs 4.4%, respectively for LB [P = 0.003] and 36.0% vs 29.0% for TE [P = 0.008]).

In patients with chronic HCV undergoing liver fibrosis staging, steatosis was detected more often with CAP than LB, with median CAP values higher in HCV monoinfection than HIV/HCV coinfection. Steatosis severity may be increasing in the modern HCV treatment era.

• HIV
• Hepatitis C
• controlled attenuation parameter
• fibrosis
• steatosis

• chronic liver disease
• cld
• diabetes
• hemophilia
• hcv
• hiv
• pwh

• Adult
• Aging/physiology
• Cross-Sectional Studies
• Disease Management
• End Stage Liver Disease/diagnosis
• End Stage Liver Disease/epidemiology
• End Stage Liver Disease/etiology
• End Stage Liver Disease/prevention & control
• Europe/epidemiology
• Female
• HIV Infections/epidemiology
• Hemophilia A/complications
• Hemophilia A/epidemiology
• Hemophilia A/therapy
• Hemophilia B/complications
• Hemophilia B/epidemiology
• Hemophilia B/therapy
• Hepatitis C, Chronic/epidemiology
• Hepatitis C, Chronic/therapy
• Humans
• Male
• Middle Aged
• Needs Assessment
• Prevalence
• Risk Factors

• DAA
• HCV
• HIV
• HLA
• IFNL3
• IFNL4
• KIR
• PegIFN/RBV
• SNP
• SVR
• adverse events
• fibrosis
• pharmacogenetics
• spontaneous resolution

• Alternative ribosomal frameshift protein
• Hepatocellular carcinoma
• Internal ribosome entry site
• Open reading frames
• Protein kinase A
• Single nucleotide polymorphism

• Carcinoma, Hepatocellular/genetics
• Carcinoma, Hepatocellular/virology
• Genome, Viral/genetics
• Hepacivirus/genetics
• Hepatitis C/complications
• Hepatitis C/genetics
• Hepatitis C/virology
• Host-Pathogen Interactions/genetics
• Humans
• Liver Neoplasms/genetics
• Liver Neoplasms/virology
• Mutation/genetics
• Polymorphism, Single Nucleotide/genetics
• Protein Interaction Maps
• Viral Proteins/genetics

• Chronic hepatitis
• Cirrhosis
• Coinfection
• Hepatocellular carcinoma
• Human immunodeficiency virus

• Adult
• Carcinoma, Hepatocellular/epidemiology
• Carcinoma, Hepatocellular/virology
• Coinfection/epidemiology
• Coinfection/virology
• Female
• HIV Infections/epidemiology
• HIV Infections/virology
• Hepacivirus/isolation & purification
• Hepatitis B virus/isolation & purification
• Hepatitis B, Chronic/epidemiology
• Hepatitis B, Chronic/virology
• Hepatitis C, Chronic/epidemiology
• Hepatitis C, Chronic/virology
• Humans
• Incidence
• Liver Cirrhosis/epidemiology
• Liver Cirrhosis/virology
• Liver Neoplasms/epidemiology
• Liver Neoplasms/virology
• Male
• Middle Aged
• Retrospective Studies

• AIDS
• Cardiovascular disease
• Deep venous thrombosis
• Hepatitis C
• ICD9CM codes
• Incidence

• Adult
• Coinfection/complications
• Female
• HIV Infections/complications
• HIV Infections/epidemiology
• Hepatitis C/complications
• Hospitalization/statistics & numerical data
• Humans
• Incidence
• Logistic Models
• Male
• Retrospective Studies
• Risk Factors
• Spain/epidemiology
• Venous Thrombosis/epidemiology
• Venous Thrombosis/etiology

• Aging
• Cancer
• Coinfection
• HIV
• HPV
• Liver disease
• Viral hepatitis

The incidence of stroke in human immunodeficiency virus (HIV)–infected individuals has been well analyzed in recent epidemiological studies. However, little is known about the specific contribution of hepatitis C virus (HCV) infection to stroke among HIV-infected individuals. The aims of this study were to analyze trends in the incidence rates of stroke in HIV-infected individuals during the combination antiretroviral (cART) era in Spain and to categorize them by the presence or absence of HCV coinfection. We analyzed hospital discharges with a diagnosis of stroke in Spain according to ICD-9-CM during 1997–2013. The study period was divided into four calendar periods (1997–1999, 2000–2003, 2004–2007, and 2008–2013). Patients were classified according to HCV serology. The number of HIV-infected patients was estimated based on data from the National Centre of Epidemiology. We calculated incidence rates (events per 10,000 patient-years) and in-hospital case fatality rates (CFR). The incidence of hemorrhagic stroke (HS) decreased in HIV-monoinfected patients (15.8 [1997–1999] to 6.5 [2008–2013]; P<0.001) and increased in HIV/HCV-coinfected patients (1.3 [1997–1999] to 5.5 [2008–2013]; P<0.001). The incidence of ischemic stroke (IS) decreased in HIV-monoinfected patients (27.4 [1997–1999] to 21.7 [2008–2013]; P = 0.005) and increased in HIV/HCV-coinfected patients (1.8 [1997–1999] to 11.9 [2008–2013]; P<0.001). The CFR was 3.3 times higher for HS than for IS for the whole study period. The CFR of HS in HIV-monoinfected patients decreased significantly (47.4% [1997–1999] to 30.6% [2008–2013]; P = 0.010) but did not change significantly among HIV/HCV-coinfected patients (41.4% [1997–1999] to 44.7% [2008–2013]; P = 0.784). The CFR of IS in the whole HIV-infected population decreased significantly (14.6% [1997–1999] to 10.9% [2008–2013]; P = 0.034), although no significant differences were found when each group was analyzed separately. In conclusion, after the introduction of cART, HS and IS rates decreased in HIV-monoinfected individuals, but increased steadily in HIV/HCV-coinfected individuals.

• Adult
• Aged
• Anti-Retroviral Agents/administration & dosage
• Brain Ischemia/drug therapy
• Brain Ischemia/epidemiology
• Brain Ischemia/etiology
• Coinfection/complications
• Coinfection/epidemiology
• Female
• HIV Infections/complications
• HIV Infections/drug therapy
• HIV Infections/epidemiology
• HIV-1
• Hepacivirus
• Hepatitis C/complications
• Hepatitis C/drug therapy
• Hepatitis C/epidemiology
• Humans
• Incidence
• Intracranial Hemorrhages/drug therapy
• Intracranial Hemorrhages/epidemiology
• Intracranial Hemorrhages/etiology
• Male
• Middle Aged
• Retrospective Studies
• Spain/epidemiology
• Stroke/epidemiology
• Stroke/etiology

• Instituto de Salud Carlos III

• Access to treatment
• Civil society
• Direct-acting antivirals
• Eastern Europe and Central Asia
• Hepatitis C
• Treatment
• Vulnerable groups

• Levi Strauss Foundation

There are several contributors to HIV-pathogenesis or insufficient control of the infection. However, whether HIV/HCV-coinfected population exhibits worst evolution of HIV-pathogenesis remains unclear. Recently, some markers of immune exhaustion have been proposed as preferentially upregulated on T-cells during HIV-infection. Herein, we have analyzed T-cell exhaustion together with several other contributors to HIV-pathogenesis that could be affected by HCV-coinfection.

Ninety-six patients with chronic HIV-infection (60 HIV-monoinfected and 36 HIV/HCV-coinfected), and 20 healthy controls were included in the study. All patients were untreated for both infections. Several CD4 and CD8 T-cell subsets involved in HIV-pathogenesis were investigated. Non-parametric tests were used to establish differences between groups and associations between variables. Multivariate linear regression was used to ascertain the variables independently associated with CD4 counts.

HIV-patients presented significant differences compared to healthy controls in most of the parameters analyzed. Both HIV and HIV/HCV groups were comparable in terms of age, CD4 counts and HIV-viremia. Compared to HIV group, HIV/HCV group presented significantly higher levels of exhaustion (Tim3⁺PD1^- subset) in total CD8⁺ T-cells (p = 0.003), and higher levels of exhaustion in CD8⁺HLADR⁺CD38⁺ (p = 0.04), CD8⁺HLADR^-CD38⁺ (p = 0.009) and CD8⁺HLADR^-CD38^- (p = 0.006) subsets of CD8⁺ T-cells. Interestingly these differences were maintained after adjusting by CD4 counts and HIV-viremia.

We show a significant impact of HCV-coinfection on CD8 T-cells exhaustion, an important parameter associated with CD8 T-cell dysfunction in the setting of chronic HIV-infection. The relevance of this phenomenon on immunological and/or clinical HIV progression prompts HCV treatment to improve management of coinfected patients.

• Adult
• CD4-Positive T-Lymphocytes/immunology
• CD8-Positive T-Lymphocytes/immunology
• Case-Control Studies
• Coinfection/etiology
• Coinfection/immunology
• Cross-Sectional Studies
• Disease Progression
• Female
• HIV Infections/complications
• HIV Infections/etiology
• HIV Infections/immunology
• Hepatitis C, Chronic/complications
• Hepatitis C, Chronic/immunology
• Humans
• Male
• Middle Aged
• Multivariate Analysis
• Statistics, Nonparametric
• Viral Load/immunology

• Direct-acting antivirals
• HCV treatment.
• HIV/AIDS
• HIV/HCV coinfection

Hyponatremia is a frequent electrolyte disorder in HIV-infected patients with a prevalence of up to 56% in the pre-cART era. Several studies have demonstrated that patients with hyponatremia are at an increased risk of death. We aimed to investigate the prevalence of hyponatremia in the recent cART-era and evaluate its association with mortality.

Single-center retrospective cohort study. A total of 1196 newly diagnosed and cART-naïve HIV patients followed at the AIDS Reference Center, St Pierre University Hospital in Brussels, Belgium, between 1 January 1998 and 31 December 2013 were included. Hyponatremia was defined as a baseline natremia lower than 135 mmol/l. The outcome of interest was the occurrence of death.

In this study 177 (14.8%) patients had hyponatremia at baseline with a median natremia of 132.0 mmol/l [interquartile range (IQR) 130.0-134.0 mmol/l]. Hyponatremic patients had a lower CD4 cell count (207.5 ± 197.7/μl vs 400.4 ± 277.0/μl; P < 0.0001) and a higher prevalence of AIDS (50.3% vs 12.4%; P < 0.0001) compared to normonatremic patients. A significantly higher proportion of patients with hyponatremia were hospitalized at first contact (72.3% vs 20.0%; P < 0.0001). During the follow-up hyponatremic patients had a shorter median time to a first hospitalization (2.0 IQR [0.0-12.0] months vs 13.0 IQR [2.0-29.0] months; P = 0.001) and an increased incident hospitalization rate (785/1000 patient-years, 95% CI 725–845 vs 370/1000 patient-years, 95% CI 352–388; P < 0.0001]. The incident mortality rate was 28.3/1000 patient-years (95% CI 18.15-42.16) in patients with hyponatremia compared to 9.33/1000 patient-years (95% CI 6.63-12.75) in normonatremic patients (P < 0.0001). Three-year cumulative survival rates were 85.8% ± 3.0% in hyponatremic patients and 96.3% ± 0.7% in normonatremic patients (log-rank P < 0.0001). However, in a multivariate Cox model adjusting for other risk factors such as AIDS, CD4 count < 350/μl and hepatitis C, hyponatremia was no longer a predictor for patient death (hazard ratio: 1.03, 95% CI 0.54-1.97; P = 0.935).

Hyponatremia is a marker of severity of HIV-disease but not an independent risk factor for mortality. HIV-patients with a low serum sodium at baseline might benefit from a close follow-up to improve outcomes.

The online version of this article (doi:10.1186/s12879-017-2191-5) contains supplementary material, which is available to authorized users.

• Acquired immunodeficiency syndrome
• Human immunodeficiency virus
• Hyponatremia
• Mortality
• Risk factors

• HCV protease inhibitor
• NS5A inhibitor
• direct-acting antivirals
• hepatitis C virus
• sustained virologic response

• DAAs
• HCV eradication
• HCV treatment
• HIV treatment
• HIV-HCV co-infection
• antiretrovirals
• drug-drug interactions
• hepatic fibrosis
• intravenous drug users
• men who have sex with men

Hepatitis C virus (HCV) infection causes significant morbidity and mortality among people who inject drugs (PWID) and HIV+ men who have sex with men (MSM). Characterizing spontaneous viral clearance of HCV infection among PWID and HIV+ MSM is important for assessing the burden of disease and treatment strategies in these populations.

Electronic and other searches of medical literature were conducted. Reports were eligible if they presented original data from upper-middle- and high-income countries on laboratory-confirmed HCV infection and spontaneous viral clearance among PWID or HIV+ MSM. Pooled estimates of spontaneous viral clearance were generated using fixed-effect and random-effects models. Meta-regression examined potential predictors related to individual characteristics and research methodology.

The meta-analysis estimated that spontaneous viral clearance occurs in 24.4 % of PWID and 15.4 % of HIV+ MSM. In univariate meta-regression among PWID, male sex and age were significantly associated with spontaneous viral clearance, and in multivariate analysis, male sex and HIV positivity were predictors of spontaneous viral clearance; among HIV+ MSM no variables were found to affect spontaneous viral clearance.

The variability in estimates of spontaneous viral clearance between HIV+ MSM and PWID suggests the impact of HIV co-infection and HCV re-infection. Due to limited data on additional factors that may affect the natural history of HCV, more research is needed to further understand spontaneous viral clearance in these risk groups.

The protocols for the PWID and HIV+ MSM research were registered with PROSPERO (CRD42014008805; CRD42013006462).

The online version of this article (doi:10.1186/s12879-016-1807-5) contains supplementary material, which is available to authorized users.

• Hepatitis C virus
• MSM
• Meta-analysis
• PWID
• Spontaneous HCV clearance
• Systematic review

Hepatitis B (HBV), hepatitis C (HCV) and other sexually transmitted infections (STIs) have been associated with HIV transmission risk and disease progression among gay men and other men who have sex with men (MSM), but the frequency and distribution of STIs in this community in Canada has not been extensively studied.

We recruited MSM living with and without HIV from a large primary care clinic in Toronto. Participants completed a detailed socio-behavioural questionnaire using ACASI and provided blood for syphilis, HIV, HBV and HCV, herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2), and human cytomegalovirus (CMV) serology, urine for chlamydia and gonorrhea, and a self-collected anal swab for human papillomavirus (HPV) molecular diagnostics. Prevalences were expressed as a proportion and compared using chi-square.

442 MSM were recruited, 294 living with HIV and 148 without. Active syphilis (11.0% vs. 3.4%), ever HBV (49.4% vs. 19.1%), HCV (10.4% vs. 3.4%), HSV-2 (55.9% vs. 38.2%), CMV (98.3% vs. 80.3%) and high-risk (HR) anal HPV (67.6% vs. 51.7%) infections were significantly more common in men living with HIV. Chlamydia and gonorrhea were infrequent in both groups. Regardless of HIV infection status, age and number of lifetime male sexual partners were associated with HBV infection and lifetime injection drug use with HCV infection.

Syphilis and viral infections, including HBV, HCV, HSV-2, CMV, and HR-HPV, were common in this clinic-based population of MSM in Toronto and more frequent among MSM living with HIV. This argues for the implementation of routine screening, vaccine-based prevention, and education programs in this high-risk population.

• Adult
• Bacterial Infections/complications
• Bacterial Infections/epidemiology
• Chlamydia Infections/complications
• Chlamydia Infections/epidemiology
• Coinfection/epidemiology
• Cytomegalovirus Infections/complications
• Cytomegalovirus Infections/epidemiology
• Disease Progression
• Gonorrhea/complications
• Gonorrhea/epidemiology
• HIV Infections/complications
• HIV Infections/epidemiology
• Hepatitis B/complications
• Hepatitis B/epidemiology
• Hepatitis C/complications
• Hepatitis C/epidemiology
• Herpes Simplex/complications
• Herpes Simplex/epidemiology
• Homosexuality, Male
• Humans
• Male
• Middle Aged
• Ontario/epidemiology
• Papillomavirus Infections/complications
• Papillomavirus Infections/epidemiology
• Prevalence
• Sexual Behavior
• Sexual Partners
• Sexually Transmitted Diseases/complications
• Sexually Transmitted Diseases/epidemiology
• Surveys and Questionnaires
• Syphilis/complications
• Syphilis/epidemiology
• Virus Diseases/complications
• Virus Diseases/epidemiology

• Canadian Institutes of Health Research

• HIV
• cohort study
• hepatitis C virus
• hepatocellular carcinoma
• liver disease

• hepatitis C
• heroin
• liver disease
• mortality
• opioid substitution treatment

• HIV
• antiviral treatment
• hepatitis C virus
• men who have sex with men
• prevention

• Antiviral Agents/therapeutic use
• Coinfection
• HIV Infections/complications
• Hepatitis C/complications
• Hepatitis C/drug therapy
• Hepatitis C/epidemiology
• Hepatitis C/prevention & control
• Homosexuality, Male
• Humans
• Incidence
• Male
• Models, Theoretical
• Prevalence
• United Kingdom/epidemiology

• RP-DG-0610-10055 Department of Health
• R01 DA037773-01A1 NIDA NIH HHS
• PDF-2011-04-049 Department of Health
• MC_UU_12014/1 Medical Research Council
• G0701627 Medical Research Council
• P30 AI036214 NIAID NIH HHS
• R01 DA037773 NIDA NIH HHS
• MR/K023233/1 Medical Research Council
• G0801822 Medical Research Council
• Wellcome Trust
• WT 102789 Wellcome Trust
• MR/M004236/1 Medical Research Council

Injecting drug users (IDU) are at premature risk of developing multimorbidity and mortality from causes commonly observed in the elderly. Ageing of the immune system (immune-senescence) can lead to premature morbidity and mortality and can be accelerated by chronic viral infections. Here we investigated the impact of HCV monoinfection and HIV/HCV coinfection on immune parameters in (ex-) IDU. We analyzed telomere length and expression of activation, differentiation and exhaustion markers on T cells at baseline (t = 1) and at follow-up (t = 2) (median interval 16.9 years) in IDU who were: HCV mono-infected (n = 21); HIV/HCV coinfected (n = 23) or multiple exposed but uninfected (MEU) (n = 8).

The median time interval between t = 1 and t = 2 was 16.9 years. Telomere length within CD4⁺ and CD8⁺ T cells decreased significantly over time in all IDU groups (p ≤ 0.012). CD4⁺ T-cell telomere length in HCV mono-infected IDU was significantly reduced compared to healthy donors at t = 1 (p < 0.008). HIV/HCV coinfected IDU had reduced CD4⁺ and CD8⁺ T-cell telomere lengths (p ≤ 0.002) to healthy donors i at t = 1. This was related to persistent levels of immune activation but not due to increased differentiation of T cells over time. Telomere length decrease was observed within all T-cell subsets, but mainly found in immature T cells (CD27⁺CD57⁺) (p ≤ 0.015).

HCV mono-infection and HIV/HCV coinfection enhance T-cell immune-senescence. Our data suggest that this occurred early during infection, which warrants early treatment for both HCV and HIV to reduce immune senescence in later life.

The online version of this article (doi:10.1186/s12979-016-0065-0) contains supplementary material, which is available to authorized users.

• Frailty
• Immunosenescence
• Longitudinal
• People who inject drugs
• Substance abuse

Hyperbilirubinaemia (HB) is common in HIV and hepatitis C virus (HIV–HCV) co-infected patients and poses a unique challenge in management as it may be due to medications such as the protease inhibitors (PIs) or to hepatic dysfunction. There are no data on the relationship of HB to liver histology and PI use in this population. Clinicians caring for these patients are faced with the difficult task of determining whether increasing serum bilirubin is due to drug effects or progression of liver disease.

To address this gap in knowledge, we performed a retrospective analysis of 344 consecutive HIV–HCV co-infected patients undergoing liver biopsy to identify factors associated with HB. Demographic, clinical, laboratory data were collected. Advanced fibrosis was defined as bridging fibrosis or cirrhosis. Those with hepatitis B virus, hepatic decompensation or hepatocellular carcinoma were excluded.

The prevalence of HB (range 1.3–9.4) was 33% and more common in those on a PI (46%) than those who were not (10%; p≤0.001) and mostly in those on indinavir (40%) or atazanavir (46%). Of the patients on these PIs, HB was not associated with fibrosis grade, demographics, or other clinical variables. Conversely, in those not on a PI, HB was associated with fibrosis grade (p≤0.0001) after adjusting for other clinical and demographic variables.

In the setting of indinavir or atazanavir use, HB is common and unrelated to underlying disease severity and the medications can be continued safely. Conversely, HB in HIV–HCV co-infected patients not on a PI is due to their underlying liver disease and suggests these patients require closer monitoring.

• DRUG INDUCED HEPATOTOXICITY
• HEPATITIS C
• HIV-RELATED GASTROINTESTINAL DISEASE

• Direct-acting antiviral agents
• HIV
• Hepatitis C
• Liver fibrosis
• Pegylated interferon

• Epidemiological study
• general population
• hepatitis C virus antibody
• risk factor

• Adolescent
• Adult
• Aged
• Child
• China/epidemiology
• Female
• Hepatitis C/epidemiology
• Humans
• Male
• Middle Aged
• Prevalence
• Risk Factors