J Korean Med Sci.  2021 Nov;36(46):e308. 10.3346/jkms.2021.36.e308.

Clinical Characteristics and Treatment Outcomes of Patients with Hepatitis C Virus and Human Immunodeficiency Virus Coinfection: Experience at a Single Center in Korea

• Lim DH
• Jeong JY
• Nam S
• Choi J
• Kwon HC
• Yoon YB
• Kim Y
• Chin B

• KMID: 2522883
• DOI: http://doi.org/10.3346/jkms.2021.36.e308

Abstract

Background
Because of the very low incidence of human immunodeficiency virus (HIV) coinfection in Korea, data on hepatitis C virus (HCV)/HIV coinfection are limited. This study aimed to investigate the clinical characteristics and treatment outcomes of patients with HCV/HIV coinfection in Korea.
Methods
We performed a retrospective cohort study of all HCV-monoinfected and HCV/ HIV-coinfected patients treated with antivirals at National Medical Center in Seoul, Korea, between January 2009 and March 2020.
Results
We enrolled 220 HCV-monoinfected and 23 HCV/HIV-coinfected patients treated with antivirals. The HCV/HIV-coinfected patients were younger (HCV vs. HCV/HIV: 57.3 ± 11.3 vs. 40.7 ± 10.1 years, P < 0.001) and had a higher proportion of men (HCV vs. HCV/ HIV: 54.5% [n = 120] vs. 91.3% [n = 21], P < 0.001) than the HCV-monoinfected patients. Genotype 1b and 2 were most common in both HCV monoinfection and HCV/HIV coinfection groups. HCV-monoinfected patients had a higher incidence of genotype 1b and 2 than HCV/HIV-coinfected patients (HCV vs. HCV/HIV: 95.4% [n = 210] vs. 73.9% [n = 17], P < 0.001), while the HCV/HIV-coinfected patients had genotype 1a (HCV vs. HCV/HIV: 1.8% [n = 4] vs. 21.7% [n = 5], P < 0.001). The fibrosis-4 index was significantly lower in the HCV/ HIV-coinfected patients than in the HCV-monoinfected patients (HCV vs. HCV/HIV: 3.81 ± 3.38 vs. 1.66 ± 1.10, P < 0.001). Among the direct-acting antivirals (DAA)-treated patients, the sustained viral response (SVR) rate did not differ significantly between both groups (HCV vs.HCV/HIV: 94.9% [93/99] vs. 90.9% [10/11], P = 0.480).
Conclusion
In Korea, the HCV/HIV-coinfected patients who received antiviral treatment were younger, had higher proportion of men and incidence of genotype 1a, and had less advanced fibrosis than the HCV-monoinfected patients. In actual clinical settings, HCV/HIV-coinfected patients show excellent SVR to DAA treatment, similar to HCVmonoinfected patients.

Keyword

Hepatitis C Virus; Human Immunodeficiency Virus; Direct-Acting Antivirals

Figure

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  Fig. 1 Flow chart of patient enrollment.HCV = hepatitis C virus, Ab = antibody, HIV = human immunodeficiency virus, GT = genotype, HBs Ag = hepatitis B surface antigen.

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  Fig. 2 Antiviral treatment regimens according to the study groups.HCV = hepatitis C virus, HIV = human immunodeficiency virus, PEG-INF = pegylated interferon-α, RBV = ribavirin, DCV = daclatasvir, ASV = asunaprevir, SOF = sofosbuvir, LDV = ledipasvir, GZR/EBR = grazoprevir/elbasvir, OBV/PTV/r = ombitasvir/paritaprevir/ritonavir, DSV = dasabuvir, GLE/PIB = glecaprevir/pibrentasvir.

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  Fig. 3 Treatment efficacy of pegylated interferon-based therapy.HCV = hepatitis C virus, HIV = human immunodeficiency virus, SVR = sustained viral response, ITT = intent-to-treat, mITT = modified intent-to-treat.

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  Fig. 4 Treatment efficacy of direct-acting antiviral agent therapy.HCV = hepatitis C virus, HIV = human immunodeficiency virus, SVR = sustained viral response, ITT = intent-to-treat, mITT = modified intent-to-treat.

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