[985] CLINICAL AND EPIDEMIOLOGICAL CHARACTERISTICS OF HEPATITIS C INFECTION IN A LARGE COHORT OF HIV-INFECTED PATIENTS IN SPAIN (GESIDA 29/02 STUDY)

2nd International AIDS Society Conference on HIV Pathogenesis and Treatment

Paris, France - July 13 - 16, 2003

[TITLE:] CLINICAL AND EPIDEMIOLOGICAL CHARACTERISTICS OF HEPATITIS C INFECTION IN A LARGE COHORT OF HIV-INFECTED PATIENTS IN SPAIN (GESIDA 29/02 STUDY)

[AUTHOR(S):] R Pacheco¹, S Hernández¹, S Diz², J Diez³, JR Arribas¹, P García⁴, C Quereda², R Rubio⁴, B Mahillo⁵, H Esteban⁵, JM Peña¹, F Pulido⁴, S Moreno², J García-Caballero³, J González-García¹ and the Grupo Cooperativo Estudio GESIDA 29/02
¹VIH H, La Paz; ²H. Ramón y Cajal; ³Med Preventiva H, La Paz; ⁴H. Doce de Octubre; and ⁵AEC GESIDA, Spain

IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd: Abstract No. 985
Antiviral Therapy 2003; 8(Suppl. 1):S462

[ABSTRACT:] Objective: To determine the prevalence and susceptibility to infection by hepatitis A (HA), hepatitis B (HB) and hepatitis C (HC) viruses of HIV-infected patients in Spain.

Patients and methods: Design: crosssectional study of a 1506 patients multicentre cohort. Patients characteristics: Mean age 40 ±7. 72% males. 50% diagnosed with HIV infection before 1992. 58% IVDA, 22% heterosexual transmission, 18% homosexual transmission. CDC stage A/B/C and 1/2/3: 38/31/31%, 7/36/57%. Median CD4 423 cells/µl. Viraemia <50 copies/ml 49%. Currently on HAART 80%.

Results: Previous history of HAART-related liver toxicity 8.7%. Regular alcohol use: any time =55%, currently >50 g/day=10%. AST normal/increased in the last 3 measurements (last year) 46/26%, ALT normal/increased in 3 consecutive measurements (last year) 36/32%. AntiHC+64.6%, HBsAg+ 4.8%, HbeAg+ 1.3%, antiHBc+ total 66.7%, antiHBs+ 39%, antiVHD (hepatitis delta, total Ab) in HBsAg+ 61%, IgG antiHA 78%. Of all patients susceptible to HA or HB infection 14% and 45% had been vaccinated respectively. Among antiHC+ patients 16% were qualitative HC serum PCR negative. HC genotypes distribution (776 tested patients): 1=51.9%, 2=2.4%, 3=27.0%, 4= 14.7%, 1&4=0.9%, undetermined=3.1%. Among HC-co-infected patients, liver biopsy has been performed in 21% (212 pt). Fibrosis score: F0=7.3%; F I=32.9%, F2=24.4%, F3=23.2%, F4=12.2%.

Conclusions: In Spain, a Mediterranean country, HIV-infected patients have a high prevalence of chronic liver disease and a high exposure to hepatitis viruses. Vaccination rates in susceptible individuals are lower than 50%. More than 50% of HBsAg+ patients have been exposed to HD. Almost one third of HC co-infected patients have a HC genotpye which can respond favourably to combined interferon and ribavirin treatment. There is a high rate of genotype 4.

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