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Soriano V, et al.
PS8/1
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Background
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It is unknown which
determine the rate of spontaneous clearance of HCV in HIV + patients
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Goal: To
characterize anti-HCV Ab+ HIV-infected patients within the EuroSIDA cohort
with regard to level of serum HCV-RNA and genotype distribution
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Methods
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All anti-HCV Ab+,
interferon-naive patients were examined for serum HCV-RNA (lower limit of
detection: 615 IU/ml) and HCV genotype.
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Logistic regression
was used to identify which variables were associated with HCV-genotype 1
(HCV-1) infection and spontaneous HCV clearance, after adjustment for
demographic, clinical and therapeutic factors.
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Results
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Injecting drug users
were less likely to have cleared spontaneously HCV infection compared to
men-having-sex-with-men (22% vs 34%, adjusted odds
ratio(aOD)=0.43(95%CI:0.32-0.58), whereas persons infected with HBV (HBsAg+)
were more likely to have cleared HCV infection (46% in HBsAg+ vs 25% in
HBsAg-, aOD=2.48 (95%CI:1.82- 3.38).
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Being female
(aOD=0.72(0.56-0.92) and older age [aOD=0.78/10 years older, (0.67-0.92)]
were also independently associated with a lower odds of being infected with
HCV-1, whereas having a higher HCV-RNA level was associated with increased
odds of HCV-1 [1.29/log10 HCV-RNA (1.14-1.47)].
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Conclusions
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3/4 of HIV patients
with detectable anti-HCV Ab in EuroSIDA show active HCV replication.
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Viremia was more
likely in injecting drug-users and in persons not chronically infected with
HBV.
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Of patients with
active HCV replication, 53% were infected by HCV-1. HCV-1 infection was
associated with higher HCV-RNA-load and male gender, and less prevalent in
Eastern Europe.
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