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hiv and liver disease

James B Maurice, Lucy Garvey, Emmanuel A Tsochatzis, Matthew Wiltshire, Graham Cooke, Naomi Guppy, Julie McDonald, Julian Marchesi, Mark Nelson, Peter Kelleher, Robert Goldin, Mark Thursz, Maud Lemoine
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is common among people living with HIV. There is limited data available on the pathophysiology of NAFLD and the development of fibrosis in this population. OBJECTIVES: to investigate the association of bacterial translocation, adipose tissue dysfunction, monocyte activation and gut dysbiosis in patients with HIV mono-infection and NAFLD. METHODS: Cases with biopsy-proven NAFLD and HIV mono-infection were age and sex-matched to HIV+ and HIV- controls...
January 14, 2019: AIDS
Nadine Kronfli, Sahir R Bhatnagar, Mark W Hull, Erica E M Moodie, Joseph Cox, Sharon Walmsley, John Gill, Curtis Cooper, Valerie Martel-Laferriere, Neora Pick, Marina B Klein
OBJECTIVE: Hepatitis C virus (HCV) treatment may reduce liver-related mortality but with competing risks, other causes of mortality may undermine benefits. We examined changes in cause-specific mortality among HIV-HCV co-infected patients before and after scale-up of HCV treatment. DESIGN: Prospective multicentre HIV-HCV cohort study in Canada. METHODS: Cause-specific deaths, classified using a modified "Coding of Cause of Death in HIV" protocol, were determined for two time periods, 2003-2012 and 2013-2017, stratified by age (20-49; 50-80 years)...
January 12, 2019: AIDS
Marion G Peters
Hepatitis B virus (HBV) infection is a lifelong dynamic disease that can be controlled with treatment but cannot yet be cured. Risk of end-stage liver disease and hepatocellular carcinoma (HCC) increases with ongoing inflammation and HBV viremia. Initial treatments consist of tenofovir or entecavir. Patients who require treatment include those with chronic hepatitis, cirrhosis, HCC, or HIV coinfection; patients receiving immunosuppressive treatments; and women in the third trimester of pregnancy who have elevated HBV DNA level...
January 2019: Topics in Antiviral Medicine
Shivakumar Narayanan, Ameer Abutaleb, Kenneth E Sherman, Shyam Kottilil
Hepatitis E virus (HEV) has traditionally been associated with an acute, self-limiting hepatitis and is not known to have any chronic sequelae. HEV genotype 1 and 2, which are human pathogens, have been associated with this self-limiting presentation, in both sporadic and epidemic settings. HEV genotype 3, which is zoonotically transmitted, is increasingly being reported as a cause of chronic infection in immunocompromised patients. These include patients with solid organ transplants, patients receiving chemotherapy for hematologic malignancies, and patients infected with HIV...
January 12, 2019: Journal of Viral Hepatitis
Stephanie J Kim, Michael J Peluso, Yongmei Wang, Daniel Bikle, Dolores Shoback, Sarah Kim
Hypercalcemia in HIV patients has been previously reported, but 1,25-(OH)2 vitamin D-mediated hypercalcemia, due to increased activity of extrarenal 1-alpha hydroxylase, is rarely described with HIV-related infections or malignancies. We describe a case of 1,25-(OH)2 vitamin D-mediated hypercalcemia in a patient presenting with progressive cognitive decline and weakness. Initial evaluation revealed a new diagnosis of HIV, for which he was started on antiretroviral therapy (ART). He was also noted to have mild asymptomatic hypocalcemia, likely from his acute illness and malnutrition, which was not further investigated at the time...
June 2019: Bone Reports
Alvin Thalappillil, Margaret V Ragni, Diane M Comer, Jonathan G Yabes
INTRODUCTION: Among haemophilic (H) men, hepatitis C virus (HCV) is the leading cause of liver disease and mortality, but demographics and risks of hepatocellular carcinoma (HCC) in H are not well known. METHODS: Adult discharges in H and non-haemophilic (NH) men, with and without HCC were identified in the National Inpatient Sample (NIS) between 1998 and 2014, using ICD-9 codes. Analyses included NIS-provided discharge-level weights to reflect national estimates...
January 7, 2019: Haemophilia: the Official Journal of the World Federation of Hemophilia
Alexander Breskin, Daniel Westreich, Christopher B Hurt, Stephen R Cole, Michael G Hudgens, Eric C Seaberg, Chloe L Thio, Phyllis C Tien, Adaora A Adimora
Background: The cost of direct-acting antivirals (DAA) for hepatitis C virus (HCV) prompted many payers to restrict treatment to patients who met non-evidence-based criteria. These restrictions have implications for survival of people with HCV, especially for people with HIV/HCVco-infection who are at high risk for liver disease progression. The goal of this work was to estimate the effects of DAA access policies on 10-year all-cause mortality among people with HIV. Methods: The study population included 3,056 adults with HIV in the Women's Interagency HIV Study and Multicenter AIDS Cohort Study from October 1, 1994 through September 30, 2015...
January 7, 2019: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Enyuan Cao, Anna Lindgren, Sofia Martinsson, Luojuan Hu, Lennart Lindfors, Kalle Sigfridsson, Urban Skantze, Erik Michaëlsson, Natalie L Trevaskis, Christopher J H Porter
Lymphocytes play a central role in the pathology of a range of chronic conditions such as autoimmune disease, transplant rejection, leukemia, lymphoma HIV/AIDs and cardiometabolic diseases such as atherosclerosis. Current treatments for lymphocyte-associated conditions are incompletely effective and/or complicated by a range of off-target toxicities. One major challenge is poor drug access to lymphocytes via the systemic blood and this may be attributed, at least in part, to the fact that lymphocytes are concentrated within lymph fluid and lymphoid tissues, particularly in gut-associated lymphatics...
January 3, 2019: Journal of Controlled Release: Official Journal of the Controlled Release Society
Rachel M Murdock, Marisa B Brizzi, Omar Perez, Melissa E Badowski
Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) co-infection among persons who inject drugs (PWID) is a major public health concern. There are limited data in clinical trials on the use of direct-acting antiviral (DAA) therapy for treatment of HCV in co-infected PWID. It is critical for these patients to gain access to treatment in order to decrease progression of liver disease and decrease transmission of both HIV and HCV. Additional harm reduction interventions, including needle and syringe programs and opioid substitution treatment, should be made available to this vulnerable population...
January 3, 2019: Infectious Diseases and Therapy
Berend J van Welzen, Tania Mudrikova, Ayman El Idrissi, Andy I M Hoepelman, Joop E Arends
The burden of liver-related morbidity remains high among HIV-infected patients, despite advances in the treatment of HIV and viral hepatitis. Especially, the impact of non-alcoholic fatty liver disease (NAFLD) is significant with a prevalence of up to 50%. The pathogenesis of NAFLD and the reasons for progression to non-alcoholic steatohepatitis (NASH) are still not fully elucidated, but insulin resistance, mitochondrial dysfunction and dyslipidemia seem to be the main drivers. Both HIV-infection itself and combination antiretroviral therapy (cART) can contribute to the development of NAFLD/NASH in various ways...
January 3, 2019: Infectious Diseases and Therapy
Brittany A Shelton, Gideon Berdahl, Deirdre Sawinski, Benjamin P Linas, Peter P Reese, Margaux N Mustian, Rhiannon D Reed, Paul A MacLennan, Jayme E Locke
End-stage renal disease (ESRD) patients co-infected with HCV and HIV have access to effective treatment options for HCV infection. However, they also have access to HCV-infected kidneys, which historically afford shorter times to transplantation. Given high waitlist mortality and rapid progression of liver fibrosis among co-infected kidney-only transplant candidates identifying the optimal treatment strategy is paramount. Two strategies, treatment pre- and post-transplant, were compared using Monte Carlo microsimulation of 1,000,000 candidates...
December 27, 2018: American Journal of Transplantation
D F Bavaro, A Saracino, D Fiordelisi, G Bruno, N Ladisa, L Monno, G Angarano
Liver fibrosis is accelerated in HIV/HCV co-infected compared with HCV mono-infected patients, due to multiple cofactors. Recently, HLA-B18 haplotype has been associated with short-term liver disease progression in this population. Our aim was to assess the influence of HLA-B18 on the fibrosis process in HIV/HCV co-infected individuals, untreated for HCV, during a long-term follow-up. All consecutive HIV/HCV co-infected patients followed in our Centre, with positive HCV-RNA and available HLA haplotypes (determined by SSO-PCR and SSR-PCR using Luminex Technology) were included...
December 22, 2018: Journal of Medical Virology
Carole Khaw, Daniel Richardson, Gail Matthews, Tim Read
Patients who are HIV-positive and co-infected with other sexually transmitted infections (STIs) are at risk of increased morbidity and mortality. This is of clinical significance. There has been a dramatic increase in the incidence of STIs, particularly syphilis, gonorrhoea, Mycoplasma genitalium and hepatitis C virus (HCV) in HIV-positive patients. The reasons for this are multifactorial, but contributing factors may include effective treatment for HIV, increased STI testing, use of HIV pre-exposure prophylaxis and use of social media to meet sexual partners...
December 21, 2018: AIDS Research and Therapy
Laura Iogna Prat, Davide Roccarina, Robert Lever, Rosa Lombardi, Alison Rodger, Andrew Hall, Tu Vinh Luong, Sanjay Bhagani, Emmanuel Tsochatzis
BACKGROUND: Spectrum of liver injury among HIV positive people is wide; in particular prevalence of non-alcoholic fatty liver disease (NAFLD) seems to be higher compared to HIV-negative people. METHODS: We retrospectively evaluated all liver biopsies performed at Royal Free Hospital from 2000 to 2017 in HIV mono-infected patients with abnormal transaminases, in order to assess the underlying cause of liver disease and to characterize the extent of fibrosis. We furthermore evaluated the diagnostic accuracy of FIB4 and Fibroscan™ as non-invasive tools for fibrosis assessment...
December 12, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Maud Lemoine, Lambert Assoumou, Stephane De Wit, Pierre-Marie Girard, Marc Antoine Valantin, Christine Katlama, Coca Necsoi, Pauline Campa, Anja D Huefner, Julian Schulze Zur Wiesch, Hayette Rougier, Jean-Philippe Bastard, Hartmut Stocker, Stefan Mauss, Lawrence Serfaty, Vlad Ratziu, Yves Menu, Jerome Schlue, Georg Behrens, Pierre Bedossa, Jacqueline Capeau, Patrick Ingiliz, Dominique Costagliola
BACKGROUND: HIV-monoinfected individuals are at high risk of non-alcoholic fatty liver disease (NAFLD). Non-invasive tests of steatosis, nonalcoholic steatohepatitis (NASH) and fibrosis have been poorly assessed in this population. Using liver biopsy (LB) as a reference, we assessed the accuracy of noninvasive methods for their respective diagnosis: MRI proton-density-fat-fraction (MRI-PDFF), Fibroscan®/CAP and biochemical tests. METHODS: We enrolled ART-controlled participants with persistently elevated transaminases and/or metabolic syndrome, and/or lipodystrophy...
December 12, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Isabelle Poizot-Martin, Eric Rosenthal, Camille Gilbert, Carla E Cano, Anne Simon, Caroline Lascoux-Combe, Laurent Alric, Anne Gervais, Didier Neau, Laure Esterle, Dominique Salmon, Philippe Sogni, Linda Wittkop
BACKGROUND: HCV and HIV infections are associated with higher risk of autoimmune diseases and T-cell dysfunction. SETTING: We evaluate prevalence and factors associated with the presence of autoimmune antinuclear (ANA), anti-smooth muscle actin (aSMA) and anti-liver kidney microsomes (aLKM1) antibodies (Ab) in HCV/HIV coinfected patients during the post-cART era. METHODS: cross-sectional observational study, nested in the ANRS CO13 HEPAVIH cohort (NCT number: NCT03324633)...
December 12, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
D Salmon-Ceron, Pierre Nahon, Richard Layese, Valérie Bourcier, Philippe Sogni, Firouze Bani-Sadr, Etienne Audureau, Laurence Merchadou, François Dabis, Linda Wittkop, Françoise Roudot-Thoraval
INTRODUCTION: It is widely accepted that HIV infection is a risk factor for increased severity of HCV liver disease. However, owing to better efficacy and safety of cART, and increased access to HCV therapy, whether this condition remains true is still unknown. METHODS: 1,253 HCV mono-infected patients and 175 HIV/HCV co-infected cirrhotic patients, included in two prospective French national cohorts (ANRS CO12 CirVir and CO13 HEPAVIH) were studied. Cirrhosis was compensated (Child-Pugh A), without prior history of complication, and assessed on liver biopsy...
December 19, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
India Butler, William MacLeod, Pappie P Majuba, Brent Tipping
Introduction: HIV-infected adults aged over 50 years in South Africa are increasing. This study explored differences between baseline characteristics and 12-month outcomes of younger and older HIV-infected adults initiated on antiretroviral therapy (ART). Additionally, associations with outcomes within the older group were sought. Methods: We retrospectively reviewed treatment-naive HIV-infected adult patients at ART initiation. Patients aged 18.0-39.9 years were compared to patients aged over 50 years using log-binomial regression for baseline characteristics and 12-month outcomes...
2018: Southern African Journal of HIV Medicine
Ross Murtagh, Davina Swan, Eileen O'Connor, Geoff McCombe, John S Lambert, Gordana Avramovic, Walter Cullen
BACKGROUND: Hepatitis C virus (HCV) infection is a major cause of chronic liver disease and death. Injection drug use is now one of the main routes of transmission of HCV in Ireland and globally with an estimated 80% new infections occurring among people who inject drugs (PWID). OBJECTIVE: We aimed to examine whether patients receiving opioid substitution therapy in primary care practices in Ireland were receiving guideline-adherent care regarding HCV screening...
December 19, 2018: Interactive Journal of Medical Research
Amine Benmassaoud, Roy Nitulescu, Thomas Pembroke, Alex S Halme, Peter Ghali, Marc Deschenes, Philip Wong, Marina B Klein, Giada Sebastiani
Background: Human immunodeficiency virus (HIV)-infected patients are at increased risk of liver-related mortality. The effect of occult cirrhosis (OcC), defined as preclinical compensated cirrhosis without any clinical findings, on liver-related events is unknown. Methods: HIV-infected patients from two Canadian cohorts underwent transient elastography (TE) examination and were classified as: 1) OcC (TE ≥13 kPa with no sign of cirrhosis, including absence of thrombocytopenia and signs of advanced liver disease on ultrasound or gastroscopy); 2) overt cirrhosis (OvC) (TE ≥13 kPa with signs of cirrhosis); 3) non-cirrhotic patients (TE <13 kPa)...
December 18, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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