Research article
The French national prospective cohort of patients co-infected with HIV and HCV (ANRS CO13 HEPAVIH): Early findings, 2006-2010
1 INSERM, U897 and ISPED, Université Victor Segalen, Bordeaux, France
2 Service des Maladies Infectieuses et Tropicales, Hôpital Cochin, AP-HP, Paris, France
3 Université Paris Descartes, Paris, France
4 INSERM, U912 (SE4S), Marseille, France
5 Université Aix Marseille, IRD, UMR-S912, Marseille, France
6 ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France
7 Service des Maladies Infectieuses et Tropicales, Hôpital Pitié Salpétrière, AP-HP, Paris, France
8 INSERM, U943, Paris, France
9 Service d'Immuno-Hématologie Clinique/CISIH, Hôpital Sainte Marguerite, Marseille, France
10 Service des Maladies Infectieuses et Tropicales, Hôpital Pellegrin, Bordeaux, France
11 Service des Maladies Infectieuses et Tropicales, Hôpital Tenon, AP-HP, Paris, France
12 Service de Médecine Interne, Hôpital de l'Archet, Nice, France
13 Service d'Hépato-Gastro-Entérologie, Hôpital Purpan, Toulouse, France
14 Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint-André, Bordeaux, France
15 Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris, France
16 Service des Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, Paris, France
17 Service de Médecine Interne - Unité VIH, Hôpital Avicenne, AP-HP, Bobigny, France
18 Service de Médecine, Hôpital Joseph Ducuing, Toulouse, France
19 Service de Médecine Interne, Hôpital Saint-Louis, AP-HP, Paris, France
20 Service des Maladies Infectieuses et Tropicales, Hôpital Paul Brousse, AP-HP, Paris, France
21 Service des Maladies Infectieuses et Tropicales, Hôpital Bicêtre, AP-HP, Paris, France
22 Service des Maladies Infectieuses et Tropicales, Groupe Hospitalier Necker-Enfants Malades, AP-HP, Paris, France
23 Institut Fédératif de Biologie, Laboratoire de Virologie, Hôpital Purpan, Toulouse, France
24 Unité d'Hépatologie, Hôpital Cochin, AP-HP, Paris, France
25 Service d'Hépato-Gastro-Entérologie, Hôpital St-Antoine, AP-HP, Paris, France
26 Service d'Hépato-Gastro-Entérologie, Hôpital Pitié Salpétrière, AP-HP, Paris, France
BMC Infectious Diseases 2010, 10:303 doi:10.1186/1471-2334-10-303
Published: 22 October 2010Abstract
Background
In France, it is estimated that 24% of HIV-infected patients are also infected with HCV. Longitudinal studies addressing clinical and public health questions related to HIV-HCV co-infection (HIV-HCV clinical progression and its determinants including genetic dimension, patients' experience with these two diseases and their treatments) are limited. The ANRS CO 13 HEPAVIH cohort was set up to explore these critical questions.
To describe the cohort aims and organization, monitoring and data collection procedures, baseline characteristics, as well as follow-up findings to date.
Methods
Inclusion criteria in the cohort were: age > 18 years, HIV-1 infection, chronic hepatitis C virus (HCV) infection or sustained response to HCV treatment. A standardized medical questionnaire collecting socio-demographic, clinical, biological, therapeutic, histological, ultrasound and endoscopic data is administered at enrolment, then every six months for cirrhotic patients or yearly for non-cirrhotic patients. Also, a self-administered questionnaire documenting socio-behavioral data and adherence to HIV and/or HCV treatments is administered at enrolment and yearly thereafter.
Results
A total of 1,175 patients were included from January 2006 to December 2008. Their median age at enrolment was 45 years and 70.2% were male. The median CD4 cell count was 442 (IQR: 304-633) cells/μl and HIV RNA plasma viral load was undetectable in 68.8%. Most participants (71.6%) were on HAART. Among the 1,048 HIV-HCV chronically co-infected patients, HCV genotype 1 was predominant (56%) and cirrhosis was present in 25%. As of January, 2010, after a median follow-up of 16.7 months (IQR: 11.3-25.3), 13 new cases of decompensated cirrhosis, nine hepatocellular carcinomas and 20 HCV-related deaths were reported, resulting in a cumulative HCV-related severe event rate of 1.9/100 person-years (95% CI: 1.3-2.5). The rate of HCV-related severe events was higher in cirrhotic patients and those with a low CD4 cells count, but did not differ according to sex, age, alcohol consumption, CDC clinical stage or HCV status.
Conclusion
The ANRS CO 13 HEPAVIH is a nation-wide cohort using a large network of HIV treatment, infectious diseases and internal medicine clinics in France, and thus is highly representative of the French population living with these two viruses and in care.
