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HCV risk sixfold higher with HIV

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Aim to diagnose and eliminate co-infection

Although these estimates of prevalence are very helpful in drawing attention to geographical areas and risk groups with high prevalence, further data and analysis are now needed to establish the extent of morbidity and mortality that can be attributed to HIV/HCV and how that might differ between populations.

Programs have many other calls on their resources, but it should be their ambition to diagnose and eliminate HCV from their HIV cohorts, and the instruments, with perhaps the exception of appropriate molecular diagnostics, are there to do it if prices for treatment can reach affordable levels.

Dr. Graham S. Cooke is from the Division of Medicine and Dr. Timothy B. Hallett is from the School of Public Health at the Imperial College London. These comments are taken from an accompanying editorial (Lancet Infect Dis. 2016 Feb 24. doi: 10.1016/S1473-3099(15)00535-6). Dr. Hallett declared grants or fees from the World Health Organization, the Bill and Melinda Gates Foundation, Global Fund, Anansi Consulting, Avenir Health, Rush Foundation, WHO, UNAIDS, and the World Bank. Dr. Cooke declared from Gilead, Janssen, and WHO.


 

FROM THE LANCET INFECTIOUS DISEASES

References

Individuals with HIV have a sixfold greater likelihood of also being infected with hepatitis C virus, according to a global systematic review and meta-analysis published in Lancet Infectious Diseases.

Researchers analyzed 783 studies of the prevalence of HIV and hepatitis C virus (HCV) infection, providing co-infection estimates for 88 countries, and found the odds of HCV infection among individuals with HIV was 5.8 times higher than in HIV-negative individuals, with an overall co-infection prevalence of 6.2% in HIV-infected individuals.

Courtesy Dr. Tom Folks, NIAID/National Institutes of Health

“People living with HIV without treatment are less likely to spontaneously clear HCV infection, have higher HCV viral loads, and experience more rapid HCV disease progression than those without HIV infection,” wrote Lucy Platt, Ph.D., from the London School of Hygiene & Tropical Medicine, and her coauthors.

The co-infection prevalence was lower in general population samples (2.4%) and pregnant or heterosexually exposed samples (4%), but slightly higher in men who have sex with men (6.4%) and significantly higher among individuals who inject drugs (82.4%).

The highest prevalence of co-infection in general population samples was in North Africa and the Middle East, while the highest prevalence of co-infection among men who have sex with men was found in North America, and the highest prevalence of co-infection among pregnant women was in western and central Africa (Lancet Infect Dis. 2016 Feb 24. doi: 10.1016/S1473-3099(15)00485-5).

The study was funded by the World Health Organization. One author declared funding from the Medical Research Council UK and membership in the STOP-HCV Consortium.

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