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Title: Viral hepatitis and HIV co-infection in the UK Collaborative HIV Cohort (UK CHIC) study
Author: Thornton, A. C.
ISNI:       0000 0004 8503 1251
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2015
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Effective treatment for HIV has led to a reduction in AIDS-related morbidity and mortality. Consequently, other co-morbidities experienced by HIV-positive people may have a significant impact on their health. Hepatitis B (HBV) and hepatitis C virus (HCV) are transmitted via the same routes as HIV, thus HIV-positive individuals are at risk of these infections. The UK Collaborative HIV Cohort (UK CHIC) study is an observational study of HIV-positive individuals attending for care at HIV centres in the UK. This thesis takes a pragmatic approach to defining co-infection within HIV cohort studies using methods that could be implemented in other HIV cohorts where similar data are known to exist. For those individuals defined as co-infected at 11 centres, a new set of data was collected including information on liver disease progression and treatment for HBV and HCV. This novel dataset was used to examine the epidemiology of HIV and hepatitis co-infection and clinical outcomes of co-infected individuals. From 2004 to 2011, the proportion of individuals in this cohort who had been tested for HBV and/or HCV had increased. The prevalence of HBV and HCV was 6.7% and 10.7%, respectively with ongoing incidence of both infections. The majority of HIV/HBV co-infected individuals (86%) received HBV-active treatment, usually with more than 1 HBV-active drug, as recommended in clinical guidelines. A smaller proportion (38%) had received treatment for HCV with 33% known to have failed treatment within one year. The risk of liver-related death was 9.0 times higher among HIV/HBV co-infected individuals and 5.7 times higher among HIV/HCV co-infected individuals than among HIV mono-infected individuals. Mortality rates were particularly high after the first liver decompensation event. Understanding the current burden of HIV and hepatitis co-infection and the clinical outcomes of co-infected individuals allows effective planning of services and monitoring of the impact of interventions.
Supervisor: Sabin, C. ; Gilson, R. Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available