Transcript Feedback from research groups: Hepatitis (Richard Gilson)

UKCHIC
Richard Gilson on behalf of the
Hepatitis Subgroup
Progress update
July 2010
UKCHIC
Hepatitis subgroup
Main focus – HBV/HCV co-infection
Data available
• Liver function tests
• HBV/HCV serology
• HBV/HCV viral load
• HBV treatment if this is a HAART component
• Limited cause of death data
UKCHIC
What have we done already
• HCV testing, prevalence, and impact on HAART outcome
(Published Jo Turner et al – JVH advance online)
• How can ALT flares best be defined
(Published Loveleen Bansi et al – JAIDS)
UKCHIC
Research questions
1.
What is the effect of hepatitis co-infection on HAART outcomes
•
•
•
•
immunological and virological response
drug toxicity
rate of treatment discontinuation
response to more potent therapies?
2.
What is the impact of hepatitis co-infection on mortality and is this
related to for eg. genotype?
3.
What is the impact of acute HCV infection on the progression of HIV
disease and response to HAART?
4.
What are the associations between HCV co-infection, ALT/AST levels
and lipid profiles?
5.
Does HBV treatment have an impact on HIV resistance development?
6.
Who requires a liver transplant and what is the outcome?
UKCHIC
Challenges – additional data
•
•
Options
–
Add data items to routine UK CHIC data download
–
Set up bespoke data collection
Additional data items
– AFP
– HCV/HBV genotype
– Resistance data – link with Resistance Database
– HBV/HCV treatment history
– Other drugs – eg EPO/GCSF/TB Rx
– Clinical – liver disease; alcohol
– Other investigations – USS; liver biopsy; Fibroscan
UKCHIC
Plan
• Agree data items
• Additional data collection – funding application
• Add data items to next data download
• Continue analyses with available data
UKCHIC
Research questions
1.
What is the effect of hepatitis co-infection on HAART outcomes
•
•
•
•
immunological and virological response
drug toxicity
rate of treatment discontinuation
response to more potent therapies?
2.
What is the impact of hepatitis co-infection on mortality and is this
related to for eg. genotype?
3.
What is the impact of acute HCV infection on the progression of HIV
disease and response to HAART?
4.
What are the associations between HCV co-infection, ALT/AST levels
and lipid profiles?
5.
Does HBV treatment have an impact on HIV resistance development?
6.
Who requires a liver transplant and what is the outcome?
UKCHIC
Research questions
1.
What is the effect of hepatitis co-infection on HAART outcomes
•
•
•
•
immunological and virological response
drug toxicity
rate of treatment discontinuation
response to more potent therapies?
2.
What is the impact of hepatitis co-infection on mortality and is this
related to for eg. genotype?
3.
What is the impact of acute HCV infection on the progression of HIV
disease and response to HAART?
4.
What are the associations between HCV co-infection, ALT/AST levels
and lipid profiles?
5.
Does HBV treatment have an impact on HIV resistance development?
6.
Who requires a liver transplant and what is the outcome?
UKCHIC
Research questions
1.
What is the effect of hepatitis co-infection on HAART outcomes
•
•
•
•
immunological and virological response
drug toxicity
rate of treatment discontinuation
response to more potent therapies?
2.
What is the impact of hepatitis co-infection on mortality and is this
related to for eg. genotype?
3.
What is the impact of acute HCV infection on the progression of HIV
disease and response to HAART?
4.
What are the associations between HCV co-infection, ALT/AST levels
and lipid profiles?
5.
Does HBV treatment have an impact on HIV resistance development?
6.
Who requires a liver transplant and what is the outcome?
UKCHIC
Research questions
1.
What is the effect of hepatitis co-infection on HAART outcomes
•
•
•
•
immunological and virological response
drug toxicity
rate of treatment discontinuation
response to more potent therapies?
2.
What is the impact of hepatitis co-infection on mortality and is this
related to for eg. genotype?
3.
What is the impact of acute HCV infection on the progression of HIV
disease and response to HAART?
4.
What are the associations between HCV co-infection, ALT/AST levels
and lipid profiles?
5.
Does HBV treatment have an impact on HIV resistance development?
6.
Who requires a liver transplant and what is the outcome?
UKCHIC
Hepatitis subgroup
Membership
Caroline Sabin
Sanjay Bhagani
Loveleen Bansi
Andrew Burroughs
Teresa Hill
Janice Main
Mark Nelson
Martin Fisher
Richard Gilson
Chris Taylor
UKCHIC
Alison Rodger