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UK CHIC. UKCHIC Richard Gilson on behalf of the Hepatitis Subgroup Progress update July 2010. UK CHIC. 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
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UKCHIC 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 • 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? • What is the impact of hepatitis co-infection on mortality and is this related to for eg. genotype? • What is the impact of acute HCV infection on the progression of HIV disease and response to HAART? • What are the associations between HCV co-infection, ALT/AST levels and lipid profiles? • Does HBV treatment have an impact on HIV resistance development? • 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 • 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? • What is the impact of hepatitis co-infection on mortality and is this related to for eg. genotype? • What is the impact of acute HCV infection on the progression of HIV disease and response to HAART? • What are the associations between HCV co-infection, ALT/AST levels and lipid profiles? • Does HBV treatment have an impact on HIV resistance development? • Who requires a liver transplant and what is the outcome?
UKCHIC Research questions • 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? • What is the impact of hepatitis co-infection on mortality and is this related to for eg. genotype? • What is the impact of acute HCV infection on the progression of HIV disease and response to HAART? • What are the associations between HCV co-infection, ALT/AST levels and lipid profiles? • Does HBV treatment have an impact on HIV resistance development? • Who requires a liver transplant and what is the outcome?
UKCHIC Research questions • 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? • What is the impact of hepatitis co-infection on mortality and is this related to for eg. genotype? • What is the impact of acute HCV infection on the progression of HIV disease and response to HAART? • What are the associations between HCV co-infection, ALT/AST levels and lipid profiles? • Does HBV treatment have an impact on HIV resistance development? • Who requires a liver transplant and what is the outcome?
UKCHIC Research questions • 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? • What is the impact of hepatitis co-infection on mortality and is this related to for eg. genotype? • What is the impact of acute HCV infection on the progression of HIV disease and response to HAART? • What are the associations between HCV co-infection, ALT/AST levels and lipid profiles? • Does HBV treatment have an impact on HIV resistance development? • 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 Alison Rodger Richard Gilson Chris Taylor