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Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) in a Northern Alberta Population

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Abstract

Objective

To describe the demographics and estimate the prevalence of hepatitis C virus (HCV) in a cohort of Human Immunodeficiency Virus (HIV) positive patients in Northern Alberta.

Methods

A cross-sectional (prevalence) study was performed on a cohort of HIV-positive patients. HCV testing was not widely available until December 1989, and the more sensitive, second generation immunoassay was not available until 1992. To reduce the effect of testing bias, we restricted consideration of HCV status to patients first seen January 1, 1992 onward.

Results

Forty-four percent of patients in the whole cohort were tested for HCV (564/1,276) and 62% (505/809) of patients entered since January 1, 1992 were tested for HCV. During the period January 1, 1992-December 31, 1999, the prevalence of HCV in our cohort of northern Alberta HIV-positive patients was at least 37.9% (307/809) and was 60.8% (307/505) among those who were tested for HCV in 1992 or later. The mean age of the coinfected group was 33.6 years, 66.1% were male, 91.2% were injection drug users (IDUs), 56.8% were Caucasian, and 40.0% were Aboriginal. A statistically significant difference was found between the HCV-negative cohort, the HCV co-infected cohort, and the HCVuntested cohort for the following variables: risk behaviour, gender, ethnic status, death, occurrence of an AIDS-defining illness (p<0.0001), and mean baseline CD4 cell count (p=0.002).

Conclusion

A high proportion of the HIV-infected IDUs was co-infected with HCV. Compared to the HCV-negative group, the co-infected group appears to have had less advanced HIV disease. This is likely a reflection of more recent HIV infection in the HCV co-infected group.

Résumé

Objectif

Décrire l’évolution démographique et estimer la prévalence du virus de l’hépatite C (VHC) au sein d’une cohorte de patients du nord de l’Alberta séropositifs pour le virus de l’immunodéficience humaine (VIH).

Méthode

Étude transversale (de prévalence) menée auprès d’une cohorte de patients séropositifs pour le VIH. Puisque le test de dépistage du VHC n’était pas généralement disponible avant décembre 1989, et que l’immuno-essai de deuxième génération, plus sensible, ne l’a été qu’en 1992, nous avons uniquement tenu compte de l’état sérologique VHC des patients vus à partir du 1er janvier 1992, afin de réduire le biais associé aux tests. Résultats: Quarante-quatre p. cent des patients de toute la cohorte avaient subi un test de dépistage du VHC (564/1 276), et 62 % (505/809) des patients vus depuis le 1er janvier 1992. Entre le 1er janvier 1992 et le 31 décembre 1999, la prévalence du VHC au sein de la cohorte était d’au moins 37,9 % (307/809), et de 60,8 % (307/505) chez les patients ayant subi un test de dépistage du VHC à partir de 1992. Le groupe co-infecté par le VIH et le VHC avait un âge moyen de 33,6 ans; il était composé à 66,1 % d’hommes, à 91,2 % d’utilisateurs de drogues injectables (UDI), à 56,8 % de Blancs et à 40 % d’Autochtones. Nous avons constaté des différences significatives (entre la cohorte des patients séronégatifs pour le VHC, celle des patients co-infectés et celle qui n’avait pas subi de test de dépistage du VHC) à l’égard des variables suivantes: la propension à prendre des risques, le sexe, l’origine ethnique, le décès, la fréquence d’une maladie définissant le sida (p<0,0001) et la concentration moyenne initiale de lymphocytes CD4 (p=0,002).

Conclusion

Une forte proportion d’UDI infectés par le VIH étaient co-infectés par le VHC. Comparé au groupe séronégatif pour le VHC, le groupe co-infecté semblait être à un stade moins avancé du VIH. Cela traduisait sans doute des infections à VIH plus récentes dans le groupe coinfecté.

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References

  1. Bureau of HIV/AIDS, STD and TB Update Series, Laboratory Centre for Disease Control. HIV/AIDS Epi update. Available on-line at: https://doi.org/www.hc-sc.gc.ca/hpb/lcdc/bah/epi/estima_e.html, November 2000.

    Google Scholar 

  2. Bruneau J, Lamothe F, Franco E, Lachance N, Desy M, Soto J, et al. High rates of HIV infection among injection drug users participating in needle exchange programs in Montreal: Results of a cohort study. Am J Epidemiol 1997;146(12):994–1002.

    Article  CAS  Google Scholar 

  3. Van der Poel CL, Cuypers HR, Reesink, HW. Hepatitis C virus six years, on. Lancet 1994;344(8935):1475–79.

    Article  Google Scholar 

  4. Boyer N, Marcellin P, Degott C, Degos F, Saimot AG, Erlinger S, et al. Recombinant Interferon-a for chronic hepatitis C in patients positive for antibody to human immunodeficiency virus. J Infect Dis 1992;165(4):723–26.

    Article  CAS  Google Scholar 

  5. Brettler DB, Alter HJ, Dienstag JL, Forsberg AD, Levine, PH. Prevalence of hepatitis C virus antibody in a cohort of hemophilia patients. Blood 1990;76(1):254–56.

    Article  CAS  Google Scholar 

  6. Brettler DB, Mannucci PM, Gringeri A, Rasko JE, Forsberg AD, Rumi MG, et al. The low risk of hepatitis C virus transmission among sexual partners of hepatitis C infected haemophiliac males: An international multicenter study. Blood 1992;80(2):540–43.

    Article  CAS  Google Scholar 

  7. Huet C, Dabis F, Saillour F, Trimoulet P, Morlat P, Rispal P, et al. Multicenter study of intrafamilial transmission of hepatitis C virus in human immunodeficiency virus infection. Gastroenterol Clin Biol 2000;24(6–7):611–17.

    CAS  PubMed  Google Scholar 

  8. Zarski JP, Leroy V. Counselling patients with hepatitis C. J Hepatol 1999;31 Suppl 1:136–40.

    Article  Google Scholar 

  9. Zou S, Tepper M, Giulivi A. Current status of hepatitis C in Canada. Can J Public Health 2000;91(Suppl. 1):S10–S15.

    Article  Google Scholar 

  10. Mele A, Tosti ME, Marzolini A, Moiraghi A, Ragni P, Gallo G, et al. Prevention of hepatitis C in Italy: Lessons from surveillance of type-specific acute viral hepatitis. SEIEVA Collaborating Group. J Viral Hepatol 2000;7(1):30–35.

    Article  CAS  Google Scholar 

  11. Conry-Cantilena C, Van Raden M, Gibble J, Melpolder J, Shakil AO, Viladomiu L, et al. Routes of infection, viremia, and liver disease in blood donors found to have hepatitis C virus infection. N Engl J Med 1996;334(26):1691–96.

    Article  CAS  Google Scholar 

  12. Alter, MJ. Epidemiology of hepatitis C. Hepatology 1997;26(3 Suppl 1):62S-65S.

    Google Scholar 

  13. Kaldor JM, Dore GJ, Correll, PK. Public health challenges in hepatitis C virus infection. J Gastroenterol Hepatol 2000;15 Suppl:E83–90.

    Article  Google Scholar 

  14. Murphy EL, Bryzman SM, Glynn SA, Ameti DI, Thomson RA, Williams AE, et al. Risk factors for hepatitis C virus infection in United States blood donors. NHLBI Retrovirus Epidemiology Donor Study (REDS). Hepatology 2000;31(3):756–62.

    Article  CAS  Google Scholar 

  15. Remis R, Hogg R, Krahn MD, et al. Estimating the number of blood transfusion recipients infected by hepatitis C virus in Canada, 1960–85 and 1990–92. Report to Health Canada, June 1998.

    Google Scholar 

  16. PPHB Surveillance. Disease Surveillance: Notifiable Diseases On-Line. https://doi.org/www.hcsc.gc.ca/pphb-dgspsp/surveillance_e.html September 2000.

    Google Scholar 

  17. Strathdee SA, Patrick DM, Currie SL, Cornelisse PG, Rekart ML, Montaner JS, et al. Needle exchange is not enough: Lessons from the Vancouver Injecting Drug Use Study. AIDS 1997;11(8):F59–65.

    Article  Google Scholar 

  18. Bowker, SL. The pathogenesis of human immunodeficiency virus in a cohort of patients co-infected with hepatitis C virus [thesis]. Edmonton, Alberta: University of Alberta, 2001.

    Google Scholar 

  19. Houston S, Rowe B, Mashinter L, Preiksaitis J, Joffe M, Mackey D, et al. Anonymous unlinked seroprevalence of HIV and hepatitis C in two emergency departments–using patient databases to distinguish previously diagnosed cases. XIII International AIDS Conference. Durban, South Africa, July 9–14, 2000. Abstract Number MoPeC2411.

    Google Scholar 

  20. Bierhoff E, Fischer HP, Willsch E, Rockstroh J, Spengler U, Brackmann HH, et al. Liver histopathology in patients with concurrent chronic hepatitis C and HIV infection. Virchows Arch 1997;430(4):271–77.

    Article  CAS  Google Scholar 

  21. Cribier B, Rey D, Schmitt C, Lang JM, Kim A, Stoll-Keller F. High hepatitis C viraemia and impaired antibody response in patients co-infected with HIV. AIDS 1995;9(10):1131–36.

    Article  CAS  Google Scholar 

  22. Castro KG, Ward JW, Slutsker L, et al. 1993 Revised Classification System for HIV Infection and Expanded Surveillance Case Definition for AIDS Among Adolescents and Adults. From the National Centre for Infectious Diseases of HIV/AIDS, Centers for Disease Control and Prevention, Atlanta, GA 1993;17:802–10.

    Google Scholar 

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Authors and Affiliations

  1. Department of Public Health Sciences, University of Alberta, 13-103 Clinical Sciences Building, Edmonton, AB, T6G 2G3, Canada

    Samantha L. Bowker MSc, Colin L. Soskolne PhD, Stephen C. Newman MD, MSc & Gian S. Jhangri MSc

  2. Department of Medicine, University of Alberta, Edmonton, Canada

    Stan C. Houston MD

Authors
  1. Samantha L. Bowker MSc
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  2. Colin L. Soskolne PhD
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  3. Stan C. Houston MD
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  4. Stephen C. Newman MD, MSc
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  5. Gian S. Jhangri MSc
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Corresponding author

Correspondence to Colin L. Soskolne PhD.

Additional information

Acknowledgements: The authors acknowledge the University of Alberta HIV Research Fund for their generous financial support. The HIV database has also been funded by the HIV program with support from the LCDC and the Capital Health Authority. This paper derives from the first author’s Master of Science thesis at the University of Alberta, entitled “The Pathogenesis of Human Immunodeficiency Virus in a Cohort of Patients Co-infected with Hepatitis C Virus”, 2001.

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Bowker, S.L., Soskolne, C.L., Houston, S.C. et al. Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) in a Northern Alberta Population. Can J Public Health 95, 188–192 (2004). https://doi.org/10.1007/BF03403646

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  • DOI: https://doi.org/10.1007/BF03403646

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