| Title: |
HCV co-infection and markers of liver injury and fibrosis among HIV-positive childbearing women in Ukraine: results from a cohort study |
| Authors: |
Bailey, Heather; Nizova, Nataliya; Martsynovska, Violeta; Volokha, Alla; Malyuta, Ruslan; Cortina-Borja, Mario; Thorne, Claire; the Ukraine European Collaborative Study in EuroCoord |
| Publisher Information: |
Zenodo |
| Publication Year: |
2016 |
| Collection: |
Zenodo |
| Subject Terms: |
HIV; Hepatitis C; Women; Liver fibrosis; Ukraine; APRI; FIB-4; Combination antiretroviral therapy; Eastern Europe |
| Description: |
Background: Ukraine's injecting drug use-driven HIV epidemic is among the most severe in Europe with high burden of HCV co-infection. HIV/HCV co-infected individuals are at elevated risk of HCV-related morbidity, but little is known about burden of liver disease and associated factors in the HIV-positive population in Ukraine, particularly among women. Methods: Characteristics of 2050 HIV-positive women enrolled into the Ukrainian Study of HIV-infected Childbearing Women were described by HCV serostatus. Aspartate transaminase (AST) to platelet ratio (APRI) and FIB-4 scores were calculated and exact logistic regression models fitted to investigate factors associated with significant fibrosis (APRI >1.5) among 762 women with an APRI score available. Results: Of 2050 HIV-positive women (median age 27.7 years, IQR 24.6-31.3), 33% were HCV co-infected (79% of those with a history of injecting drug use vs 23% without) and 17% HBsAg positive. A quarter were on antiretroviral therapy at postnatal cohort enrolment. 1% of the HIV/HCV co-infected group had ever received treatment for HCV. Overall, 24% had an alanine aminotransferase level >41 U/L and 34% an elevated AST (53% and 61% among HIV/HCV co-infected). Prevalence of significant fibrosis was 4.5%; 2.5% among 445 HIV mono-infected and 12.3% among 171 HIV/HCV co-infected women. 1.2% had a FIB-4 score >3.25 indicating advanced fibrosis. HCV RNA testing in a sub-group of 56 HIV/HCV co-infected women indicated a likely spontaneous clearance rate of 18% and predominance of HCV genotype 1, with one-third having genotype 3 infection. Factors associated with significant fibrosis were HCV co-infection (AOR 2.53 95%CI 1.03-6.23), history of injecting drug use (AOR 3.51 95%CI 1.39-8.89), WHO stage 3-4 HIV disease (AOR 3.47 95%CI 1.51-7.99 vs stage 1-2 HIV disease) and not being on combination antiretroviral therapy (AOR 3.08 95%CI 1.23-7.74), adjusted additionally for HBV co-infection, smoking and age. Conclusions: Most HIV/HCV co-infected women had elevated liver ... |
| Document Type: |
article in journal/newspaper |
| Language: |
unknown |
| Relation: |
https://zenodo.org/communities/fp7-bmc/; https://zenodo.org/communities/eu/; https://zenodo.org/records/322845; oai:zenodo.org:322845 |
| DOI: |
10.1186/s12879-016-2089-7 |
| Availability: |
https://doi.org/10.1186/s12879-016-2089-7; https://zenodo.org/records/322845 |
| Rights: |
Creative Commons Attribution 4.0 International ; cc-by-4.0 ; https://creativecommons.org/licenses/by/4.0/legalcode |
| Accession Number: |
edsbas.9DD66365 |
| Database: |
BASE |