Clinical and virological characteristics of HIV neg. and HIV pos. individuals infected by HCV genotype 4: data from an Italian Center

Andrea Andolina

Background Hepatitis C virus (HCV) genotype (G) 4 represents 12%-15% (15-18 million) of total global HCV infection. G4 is prevalent in Northern and Equatorial Africa and the Middle East, and is also present in some countries in Europe. In Italy, G4 prevalence is 1.4%-3.1%. Aim To evaluate clinical and virological characteristics of HIV neg. and HIV pos. individuals infected by HCV G4 attending Infectious Diseases Dept. Ospedale San Raffaele, (Milan, Italy). Methods Of 950 HIV/HCV coinfected individuals and 200 HCV monoinfected pts. attending our Center, were selected individuals infected by HCVG4 on the basis of data retrieved from an internal database. Clinical and virological data before IFN-based and/or direct acting antivirals (DAAs) based treatment were analyzed in 139 G4 infected patient: 82/950 HIV pos. (8.6%) and 57/200 HIV neg. (28.5%). Statistical analysis was performed using Fisher exact test or Chi-square test for categorical variables and using Mann-Whitney non parametric test for continuous variables. Data were expressed as median and interquartile range (IQR). Results: HIV infected pts. showed HIV viral load 350 cell/mmc before treatment. Clinical and virological characteristics of HIV neg and HIV pos pts are described in Table 1. Comparison between the two groups showed that sex, age and geographical origin were different: HIV neg. pts. were younger, prevalently males and came more frequently from Northern Africa. HIV pos. pts. were more frequently Italian, and 32% were females. The distribution of G4 subtypes was different between the two groups. Interestingly, G4 subtype was not available in a number of HIV neg pts. There was no significant difference in the grade of fibrosis and stiffness values. HIV neg. pts. were more frequently treated with IFN-based regimen than HIV pos. while HIV pos. pts. showed a higher HCV load. IFN-based treatment outcome showed a trend towards significance. Fourteen HIV neg. pts. received a DAAs-based therapy, 7 of them were naïve to treatment and 7 were non-responder (NR) to previous IFN-based regimens. Thirteen HIV pos. pts. received a DAAs based therapy, 7 of them were naïve to treatment and 6 were NR to previous treatment. Conclusions Despite the presence of some differences in these two groups reflecting at least in part the different geographical origin, the hepatic disease burden was similar between HIV neg. and HIV pos. subjects infected by G4.

Simone Agnello
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