3rd International AIDS Society Conference on HIV Pathogenesis and Treatment Rio de Janeiro - July 24 - 27, 2005

EFFECT OF HIV CO-INFECTION ON SPONTANEOUS CLEARANCE OF HEPATITIS C VIRUS (HCV) IN THE DOWNTOWN EASTSIDE OF VANCOUVER

IAS Conf HIV Pathog Treat 2005 Jul 24-27;3rd: Abstract No. TuPe1.1C18

Grebely J.¹, Conway B.¹, Raffa J.², Lai C.³, Krajden M.⁴, Kerr T.³, Wood E.³, Tyndall M.^3
1Department of Pharmacology and Therapeutics, University of British Columbia, Vancouver, Canada, ²Department of Statistics, University of British Columbia, Vancouver, Canada, ³BC Centre for Excellence in HIV/AIDS, Vancouver, Canada, 4BC Centre for Disease Control, Vancouver, Canada

INTRODUCTION: The factors associated with spontaneous clearance of HCV infection (such as HIV co-infection) are not well described, and could be studied in a large, observational cohort in where all relevant parameters are measured.

METHODS: The CHASE Project is a prospective cohort study of residents of the Downtown Eastside of Vancouver with high endemic rates of injection drug use. The demographic information from this cohort was linked with the virology database of the BC Centre for Disease Control (BCCDC) to establish the clinical and laboratory correlates of spontaneous clearance of HCV infection (HCV Ab+/RNA-).

RESULTS: In total, 1,202 HCV antibody-seropositive subjects (63.5% prevelance in 1,893 subjects) were tested between 1991 and 2004. Of these, 523 (326 males and 197 females, overall mean age=41.1) were tested for HCV RNA. Patients having received treatment for HCV were omitted. To define the role of gender, age, previous hepatitis B virus (HBV) infection and HIV co-infection in spontaneous HCV clearance, we examined these parameters in 123 subjects (HCV Ab+/RNA-) and 400 chronically HCV-infected subjects (HCV Ab+/RNA+). Spontaneous clearance was observed in 23.5% subjects. Co-infection with HIV and HBV was observed in 18.5% and 3.1% of patients, respectively. In a multivariate logistic regression analysis, female gender (adjusted odds ratio [AOR] 2.6; 95% CI, 1.7-4.1; P<0.001) and previous co-infection with HBV (AOR 6.8; 95% CI, 2.3-20.2, P<0.001) were associated with increased likelihood of clearance. Co-infection with HIV was negatively associated with spontaneous HCV clearance (AOR 0.42; 95% CI, 0.23-0.79 P=0.007). Re-infection with HCV was observed in 7/123 (5.7%) patients who spontaneously cleared the virus.

CONCLUSIONS: In this large community cohort, the prevalence of HCV and HIV/HCV co-infection were high at 63.5% and 18.5%, respectively. Co-infection with HIV and male gender decreases the likelihood of spontaneous clearance of HCV, while the presence of previous co-infection with HBV increases its likelihood.

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Clinical | TuPe1.1C18 | Jason Grebely
Hepatitis viruses

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