18 research outputs found
Investigating rates and predictors of viral blips, low-level viraemia and virological failure in the Australian HIV observational database
No full textObjectives: Australia has made significant progress towards achieving the UNAIDS's 95-95-95 cascade targets including HIV viral suppression. To investigate the burden of HIV viraemia, we assessed viral blips, low-level viraemia (LLV) and virologic failure (VF) in an Australian cohort. Methods: We studied the proportion of people with viral suppression, viral blips, LLV and VF in the Australian HIV observational database (AHOD) between 2010 and 2021. The association between blips or LLV, and VF was investigated using Cox regression, and predictors of viral blips and LLV were assessed using repeated-measured logistic regression. Results: Among 2544 AHOD participants who were in follow-up and on antiretroviral therapy (ART) from 1 January 2010 (88.7% male), 444 had experienced VF (incidence rate: 2.45 [95% CI: 2.23–2.69] per 100 person-years [PY]) during 18,125 PY of follow-up (a median of 7.6 years). The proportion of people with VF decreased over time, whereas rates of blips and LLV remained stable. Participants with blips (hazard ratio, 2.89; 95% CI: 2.31–3.61) and LLV (4.46; 95% CI: 3.38–5.89) were at increased risk of VF. Hepatitis B co-infection, longer documented treatment interruption duration, younger age and lower CD4 at ART initiation, and protease inhibitors-based initial regimen were associated with an increased risk of VF. Common predictors of blips and LLV such as higher HIV-1 RNA and lower CD4 at ART initiation, longer treatment interruption, more VL testing and types of care settings (hospitals vs. sexual health services) were identified. Conclusions: Blips and LLV predict subsequent VF development. We identified important predictors of HIV viraemia including VF among individuals on INSTI-based regimens to help direct HIV management plans
Anonymised data set.
No full textHCV = Hepatitis C Virus, HBV = Hepatitis B Virus, HIV = Human immunodeficiency virus, kPa = kilopascal, IQR = Interquartile range, AST = aspartate aminotransferase, AST ULN = aspartate aminotransferase upper limit of normal, ALT = alanine aminotransferase level, GGT = ɣ-glutamyl transpeptidase, INR = international normalised ratio. Site information has been anonymised. (PDF)</p
Characteristics of subjects with HCV mono-infection and HCV co-infection.
No full textCharacteristics of subjects with HCV mono-infection and HCV co-infection.</p
DAA treatment scale-up in HIV/HCV co-infection: characterisinga population at risk for reinfection
No full textIndices utilised in the non-invasive algorithms included.
No full textIndices utilised in the non-invasive algorithms included.</p
Capacity of non-invasive hepatic fibrosis algorithms to replace transient elastography to exclude cirrhosis in people with hepatitis C virus infection: A multi-centre observational study - Fig 2
No full textHepatitis C Mono-infected validation cohort showing A) APRI, B) FIB-4, C) Forns’ & D) GUCI scores with published and newly derived cut-off values compared with cirrhosis. Solid horizontal lines indicate published cut-off values. Dashed horizontal lines indicate newly derived cut-off values. Dashed vertical line indicates TE-defined cirrhosis. TE = transient elastography, kPa = kilopascal.</p
Performance of non-invasive fibrosis algorithms in excluding cirrhosis in people with HCV infection.
No full textPerformance of non-invasive fibrosis algorithms in excluding cirrhosis in people with HCV infection.</p
Capacity of non-invasive hepatic fibrosis algorithms to replace transient elastography to exclude cirrhosis in people with hepatitis C virus infection: A multi-centre observational study - Fig 1
No full textHepatitis C Mono-infected derivation cohort showing A) APRI, B) FIB-4, C) Forns’ & D) GUCI scores with published and newly derived cut-off values compared with cirrhosis. Solid horizontal lines indicate published cut-off values. Dashed horizontal lines indicate newly derived cut-off values. Dashed vertical line indicates TE-defined cirrhosis. TE = transient elastography, kPa = kilopascal.</p
Performance of combinations of non-invasive fibrosis algorithms in excluding cirrhosis in people with HCV infection.
No full textPerformance of combinations of non-invasive fibrosis algorithms in excluding cirrhosis in people with HCV infection.</p
Antiretroviral use in the CEASE cohort study and implications for direct-acting antiviral therapy in human immunodeficiency virus/hepatitis C virus coinfection
No full textBackground. Interferon-free direct-acting antiviral (DAA) regimens for hepatitis C virus (HCV) provide a major advance in clinical management, including in human immunodeficiency virus (HIV)/HCV coinfection. Drug-drug interactions (DDIs) with combination antiretroviral therapy (cART) require consideration. This study aimed to characterize the cART regimens in HIV/HCV-coinfected individuals and assess the clinical significance of DDIs with DAAs in a real-world cohort.Methods. This analysis included participants enrolled in CEASE-D, a prospective cohort of HIV/HCV-coinfected individuals in Sydney, Australia, between July 2014 and December 2015. A simulation of potential DDIs between participants' cART and interferon-free DAA regimens was performed using www.hep-druginteractions.org and relevant prescribing information.Results. In individuals on cART with HCV genotype (GT) 1 and 4 (n = 128), category 3 DDIs (contraindicated or not recommended) were noted in 0% with sofosbuvir/ledipasvir, 0% with sofosbuvir plus daclatasvir, 17% with sofosbuvir/velpatasvir, 36% with ombitasvir/paritaprevir/ritonavir ± dasabuvir, 51% with grazoprevir/elbasvir, and 51% with sofosbuvir plus simeprevir; current cART regimens were suitable for coadministration in 100%, 100%, 73%, 64%, 49%, and 49%, respectively. In individuals with HCV GT 2 or 3 (n = 53), category 3 DDIs were evident in 0% with sofosbuvir plus daclatasvir, 0% with sofosbuvir and ribavirin, and 13% with sofosbuvir/velpatasvir; current cART regimens were suitable in 100%, 100%, and 81%, respectively.Conclusions. Potential DDIs are expected and will impact on DAA prescribing in HIV/HCV coinfection. Sofosbuvir in combination with an NS5A inhibitor or ribavirin appeared to be the most suitable regimens in this cohort. Evaluation of potential DDIs is required to prevent adverse events or treatment failure
