New and noteworthy
CATIE News: Liver cancer rates low in people with HIV and hepatitis C
People with HIV and hepatitis C coinfection have low rates of liver cancer (about 1%), reported researchers in Clinical Infectious Diseases.
This study drew information from four databases of people coinfected with HIV and hepatitis C and included 7,229 participants. Two Canadian databases were used, the Canadian Co-infection Cohort and the Southern Alberta Clinic Cohort, along with two European databases.
The average age of participants was 38 years and the majority of participants were men. Nearly all participants were receiving HIV treatment.
There were a total of 72 cases (about 1%) of liver cancer. Over the course of the study the risk of liver cancer increased by 11% per year.
The following were statistically linked to an increased risk for liver cancer:
- the presence of cirrhosis
- being older
- triple infection with hepatitis B
- a lower current CD4+ cell count
As more people with HIV and hepatitis C coinfection are cured of hepatitis C through treatment it is likely that the rates of liver cancer will become even lower among people who are coinfected with HIV and hepatitis C. (catie.ca, June 2016, in English)
High cure rates for Epclusa in people with HIV and hepatitis C coinfection
A late-stage clinical study of Epclusa had high cure rates (95%) in people with HIV and hepatitis C coinfection, reported researchers at the 21st International AIDS Conference.
Epclusa is a combination of two direct acting anti-viral medications, sofosbuvir and velpatasvir, which are taken together in one pill. Epclusa is taken once per day for 12 weeks.
There were 107 people in the study. The majority were men and just under half were Black. The average age was 54 years old. The majority of participants (73%) had genotype 1 virus, 10% had genotype 2, 11% had genotype 3 and 5% had genotype 4. There were no participants with genotypes 5 or 6 virus.
All participants were on HIV treatment and had an undetectable HIV viral load. Eighteen percent had cirrhosis.
Treatment was generally safe and well tolerated. The most common side effects were fatigue and headache.
“Sofosbuvir/velpatasvir for 12 weeks provides a simple, safe and highly effective treatment for patients coinfected with HIV-1 and hepatitis C,” the researchers concluded. (HIVandhepatitis.com, July 2016, in English)
Low hepatitis C viral load, female gender associated with late spontaneous clearance of hepatitis C
While late spontaneous clearance of hepatitis C is rare, it is more common in women and people with low hepatitis C viral loads, reported researchers in the Journal of Hepatology.
Using data from a large Scottish cohort collected between 1994 and 2014, the researchers selected cases of untreated people they determined to have late spontaneous hepatitis C clearance (two positive hepatitis C RNA samples more than six months apart followed by more than one negative test).
They were compared with a control group of 200 cases of untreated people who had not spontaneously cleared hepatitis C (they had greater than two positive hepatitis C RNA samples more than six months apart with no negative samples).
There were 50 cases of late spontaneous hepatitis C clearance. The midpoint of time at which clearance happened in the group was 50 months. People who spontaneously cleared hepatitis C were more likely to be female. Also, in comparison to the control group, in general they had lower levels of hepatitis C viral load.
Spontaneous clearance of HCV was also found to be associated with younger age at infection and coinfection with hepatitis B virus infection.
According to the researchers, “given that such clearance may occur after a prolonged duration of infection, more regular serum hepatitis C RNA monitoring may be warranted, particularly in females, patients coinfected with hepatitis B [and] patients with low level viremia…”. (healio.com, June 2016, in English)