HCV-Related Mortality Among HIV/HCV Co-infected Patients: The Importance of Behaviors in the HCV Cure Era (ANRS CO13 HEPAVIH Cohort)

Abstract

Mortality among individuals co-infected with HIV and hepatitis C virus (HCV) is relatively high. We evaluated the association between psychoactive substance use and both HCV and non-HCV mortality in HIV/HCV co-infected patients in France, using Fine and Gray’s competing-risk model adjusted for socio-demographic, clinical predictors and confounding factors, while accounting for competing causes of death. Over a 5-year median follow-up period, 77 deaths occurred among 1028 patients. Regular/daily cannabis use, elevated coffee intake, and not currently smoking were independently associated with reduced HCV-mortality (adjusted sub-hazard ratio [95% CI] 0.28 [0.10–0.83], 0.38 [0.15–0.95], and 0.28 [0.10–0.79], respectively). Obesity and severe thinness were associated with increased HCV-mortality (2.44 [1.00–5.93] and 7.25 [2.22–23.6] versus normal weight, respectively). Regular binge drinking was associated with increased non-HCV-mortality (2.19 [1.10–4.37]). Further research is needed to understand the causal mechanisms involved. People living with HIV/HCV co-infection should be referred for tobacco, alcohol and weight control interventions and potential benefits of cannabis-based therapies investigated.

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Acknowledgements

English review: Jude Sweeney. Patients in the HEPAVIH Cohort. Scientific Committee of the ANRS CO13 HEPAVIH Study Group: D. Salmon (co-Principal investigator), L. Wittkop (co-Principal Investigator), P. Sogni (co-Principal Investigator), L. Esterle (project manager), P. Trimoulet, J. Izopet, L. Serfaty, V. Paradis, B. Spire, P. Carrieri, M.A. Valantin, G. Pialoux, J. Chas, I. Poizot-Martin, K. Barange, A. Naqvi, E. Rosenthal, A. Bicart-See, O. Bouchaud, A. Gervais, C. Lascoux-Combe, C. Goujard, K. Lacombe, C. Duvivier, D. Vittecoq, D. Neau, P. Morlat, F. Bani-Sadr, L. Meyer, F. Boufassa, S. Dominguez, B. Autran, A.M. Roque, C. Solas, H. Fontaine, D. Costagliola, L. Piroth, A. Simon, D. Zucman, F. Boué, P. Miailhes, E. Billaud, H. Aumaître, D. Rey, G. Peytavin, V. Petrov-Sanchez, A. Pailhé. Clinical Centres (ward/participating physicians): APHP Cochin, Paris (Médecine Interne et Maladies Infectieuses: D. Salmon, R. Usubillaga; Hépato-gastro-entérologie: P. Sogni; Anatomo-pathologie: B. Terris; Virologie :P. Tremeaux); APHP Pitié-Salpétrière, Paris (Maladies Infectieuses et Tropicales: C. Katlama, M.A. Valantin, H. Stitou; Hépato-gastro-entérologie: Y. Benhamou; Anatomo-pathologie: F. Charlotte; Virologie: S. Fourati); APHP Pitié-Salpétrière, Paris (Médecine Interne: A. Simon, P. Cacoub, S. Nafissa); APHM Sainte-Marguerite, Marseille (Service d’Immuno-Hématologie Clinique: I. Poizot-Martin, O. Zaegel, H. Laroche; Virologie: C. Tamalet); APHP Tenon, Paris (Maladies Infectieuses et Tropicales: G. Pialoux, J. Chas,; Anatomo-pathologie: P. Callard, F. Bendjaballah; Virologie: C. Le Pendeven); CHU Purpan, Toulouse (Maladies Infectieuses et Tropicales: B. Marchou; Hépato-gastro-entérologie: L. Alric, K. Barange, S. Metivier; Anatomo-pathologie: J. Selves; Virologie: F. Larroquette); CHU Archet, Nice (Médecine Interne: E. Rosenthal; Infectiologie: A. Naqvi, V. Rio; Anatomo-pathologie: J. Haudebourg, M.C. Saint-Paul; Virologie: C. Partouche); APHP Avicenne, Bobigny (Médecine Interne – Unité VIH: O. Bouchaud; Anatomo-pathologie: M. Ziol; Virologie: Y. Baazia); Hôpital Joseph Ducuing, Toulouse (Médecine Interne: M. Uzan, A. Bicart-See, D. Garipuy, M.J. Ferro-Collados; Anatomo-pathologie: J. Selves; Virologie: F. Nicot); APHP Bichat – Claude-Bernard, Paris (Maladies Infectieuses :, A. Gervais, Y. Yazdanpanah; Anatomo-pathologie: H. Adle-Biassette; Virologie: G. Alexandre); APHP Saint-Louis, Paris (Maladies infectieuses: C. Lascoux-Combe, J.M. Molina,; Anatomo-pathologie: P. Bertheau,; Virologie :M.L. Chaix, C. Delaugerre, S. Maylin); APHP Saint-Antoine (Maladies Infectieuses et Tropicales :, K. Lacombe, J. Bottero; J. Krause P.M. Girard, Anatomo-pathologie: D. Wendum, P. Cervera, J. Adam; Virologie: C. Viala); APHP Bicêtre, Paris (Médecine Interne: C. Goujard, Y. Quertainmont, E. Teicher; Virologie: C. Pallier; Maladies Infectieuses: D. Vittecoq); APHP Necker, Paris (Maladies Infectieuses et Tropicales: O. Lortholary, C. Duvivier, C. Rouzaud, J. Lourenco, F. Touam, C. Louisin: Virologie: V. Avettand-Fenoel, A. Mélard); CHU Pellegrin, Bordeaux (Maladies Infectieuses et Tropicales: D. Neau, A. Ochoa, E. Blanchard, S. Castet-Lafarie, C. Cazanave, D. Malvy, M. Dupon, H. Dutronc, F. Dauchy, L. Lacaze-Buzy; Anatomo-pathologie: P. Bioulac-Sage; Virologie: P. Trimoulet, S. Reigadas); Hôpital Saint-André, Bordeaux (Médecine Interne et Maladies Infectieuses: Médecine Interne et Maladies Infectieuses: P. Morlat, D. Lacoste, F. Bonnet, N. Bernard, M. Hessamfar, J, F. Paccalin, C. Martell, M. C. Pertusa, M. Vandenhende, P. Merciéer, D. Malvy, T. Pistone, M.C. Receveur, M. Méchain, P. Duffau, C Rivoisy, I. Faure, S. Caldato; Anatomo-pathologie: P. Bioulac-Sage; Virologie: P. Trimoulet, S. Reigadas); Hôpital du Haut-Levêque, Bordeaux (Médecine Interne: J.L. Pellegrin, J.F. Viallard, E. Lazzaro, C. Greib; Anatomo-pathologie: P. Bioulac-Sage; Virologie: P. Trimoulet, S. Reigadas); Hôpital FOCH, Suresnes (Médecine Interne: D. Zucman, C. Majerholc; Virologie: E. Farfour); APHP Antoine Béclère, Clamart (Médecine Interne: F. Boué, J. Polo Devoto, I. Kansau, V. Chambrin, C. Pignon, L. Berroukeche, R. Fior, V. Martinez; Virologie: C. Deback); CHU Henri Mondor, Créteil (Immunologie Clinique: Y. Lévy, S. Dominguez, J.D. Lelièvre, A.S. Lascaux, G. Melica); CHU Hôtel Dieu, Nantes (Maladies Infectieuses et Tropicales: E. Billaud, F. Raffi, C. Allavena, V. Reliquet, D. Boutoille, C. Biron; Virologie: A. Rodallec, L. Le Guen); Hôpital de la Croix Rousse, Lyon (Maladies Infectieuses et Tropicales: P. Miailhes, D. Peyramond, C. Chidiac, F. Ader, F. Biron, A. Boibieux, L. Cotte, T. Ferry, T. Perpoint, J. Koffi, F. Zoulim, F. Bailly, P. Lack, M. Maynard, S. Radenne, M. Amiri; Virologie: C. Scholtes, T.T. Le-Thi); CHU Dijon, Dijon (Département d’infectiologie :, L. Piroth, P. Chavanet M. Duong Van Huyen, M. Buisson, A. Waldner-Combernoux, S. Mahy, R. Binois, A.L. Simonet-Lann, D. Croisier-Bertin); CH Perpignan, Perpignan (Maladies infectieuses et tropicales: H. Aumaître); CHU Robert Debré, Reims (Médecine interne, maladies infectieuses et immunologie clinique: F. Bani-Sadr, D. Lambert, Y Nguyen, J.L. Berger); CHRU Strasbourg (Le Trait d’Union: D Rey, M Partisani, ML Batard, C Cheneau, M Priester, C Bernard-Henry, E de Mautort, Virologie: P Gantner et S Fafi-Kremer), APHP Bichat-Claude Bernard (Pharmacologie: G. Peytavin). Data collection: F. Roustant, I. Kmiec, L. Traore, S. Lepuil, S. Parlier, V. Sicart-Payssan, E. Bedel, F. Touam, C. Louisin, M. Mole, C. Bolliot, M. Mebarki, A. Adda-Lievin, F.Z. Makhoukhi, O. Braik, R. Bayoud, M.P. Pietri, V. Le Baut, D. Bornarel, C. Chesnel, D. Beniken, M. Pauchard, S. Akel, S. Caldato, C. Lions, L. Chalal, Z. Julia, H. Hue, A. Soria, M. Cavellec, S. Breau, A. Joulie, P. Fisher, C. Ondo Eyene, S. Ogoudjobi, C. Brochier, V. Thoirain-Galvan. Management, statistical analyses: E. Boerg, P. Carrieri, V. Conte, L. Dequae-Merchadou, M. Desvallees, N. Douiri, L. Esterle, C. Gilbert, S. Gillet, R. Knight, F. Marcellin, L. Michel, M. Mora, C. Protopopescu, P. Roux, B. Spire, S. Tezkratt, I. Yaya, T. Barré, T. Rojas Rojas, V. Villes, M. Baudoin, M. Santos.

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ANRS (France Recherche Nord & sud Sida-hiv Hépatites).

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Study concept and design: MPC, CP, DSC. Acquisition of data: LW, LE, LP, FB, ER, PM, PS, DSC. Analysis and interpretation of data: CP, MES, MPC. Drafting of the manuscript: MES, MPC, CP, FM. Critical revision of the manuscript for important intellectual content: MPC, FM, DSC, WNA, LW, LE, ER, PS, PM, IY, PR, LP, FB. Statistical analysis: CP. Obtained funding: LW, MPC. Administrative, technical, or material support: FM, LE. Study supervision: MPC. All authors approved the final revised version of the manuscript.

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Correspondence to Maria Patrizia Carrieri.

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The members of the ANRS CO13 HEPAVIH Study Group are listed in the acknowledgements.

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Santos, M.E., Protopopescu, C., Sogni, P. et al. HCV-Related Mortality Among HIV/HCV Co-infected Patients: The Importance of Behaviors in the HCV Cure Era (ANRS CO13 HEPAVIH Cohort). AIDS Behav 24, 1069–1084 (2020). https://doi.org/10.1007/s10461-019-02585-7

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Keywords

  • Behavior
  • Substance use
  • Hepatitis C
  • HIV
  • Mortality