QUALI DIFFERENZE IN RAPPORTO AL SESSO NELLA COINFEZIONE HCV/HIV? I DATI ITALIANI DALLA COORTE ICONA Antonella Cingolani Clinica Malattie Infettive, UCSC,

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QUALI DIFFERENZE IN RAPPORTO AL SESSO NELLA COINFEZIONE HCV/HIV? I DATI ITALIANI DALLA COORTE ICONA Antonella Cingolani Clinica Malattie Infettive, UCSC, Roma

Gender-based approach to cohort data in HIV/HCV coinfection Prevalence/incidence data Difference in liver damage Difference in liver disease progression Different access to treatment

HBsAg and HCVAb positivity according to gender in patients from ICONA Jun 2015 Report

HCVAb pos according to gender and mode of HIV transmission in ICONA patients Jun 2015 Report

Proportion of HCV genotypes for HCV-RNA+ patients in ICONA Jun 2015 Report

Last Fib4 values for HCVAb positive patients in ICONA, naive or failed at any anti-HCV therapy Dec 2014 Report

Cause of death by gender for HCVAb+ patients Jun 2015 Report

Baseline characteristics of women in Icona cohort according to HCV status HCV+ N=782 HCV- N=1872 p Age, median (IQR)35 (31-38)34 (29-41)0.13 Caucasian race, n (%)762 (97.4)1424 (76.1)<0.001 HIV transmission route, n (%) IVDU Heterosex Homosex 513 (65) 244 (31.2) - 66 (3.5) 1656 (88.5) 1 (0.05) <0.001 Year of enrollment, median (IQR)1998 (97-00)2002 (98-01)<0.001 HBsAg+, n (%)20/708 (2.8)58/1791 (3.2)0.59 Years from HIV diagnosis, median (IQR)5 (1-10)1 (0-3)<0.001 AIDS at baseline, n (%)76 (9.7)209 (11.2)0.27 Baseline CD4/mmc, median (IQR)435 ( )411 ( )0.05 Baseline CD4/CD8, median (IQR)0.54 ( )0.51 ( )0.12 On ART at baseline, n (%)39 (4.9)171 (9.1)0.003 HIV-RNA, log10 c/ml, median (IQR)4.2 ( ) 0.98

Predictors of HCV coinfection Female population Male population Variables of adjustment: Age, HBsAg+, AIDS, CD4, CD4/CD8, HIV-RNA

Liver impairment in HCV+ patients according to gender Male (n=2233)Female (n=782)p APRI >1, n(%)803 (35.9)185 (23.7)<.0001 FIB4>3.25 n(%)356/2094 (17)80/739 (11)<.0001 Diabetes20 (0.9)1 (0.1).02 eGFR <=80, n%27/429 (6.3)7/152 (4.6).44 Col Tot mg/dL, median (IQR)150 ( )160 ( ).002 Col HDL mg/dL, median (IQR)38 (30-47)45 (33-58)<.0001 INR, median (IQR)1.04 ( )1.01 ( ).31 Albumina g/dL, median (IQR)4.2 ( )4.0 ( ).10 Pche UI/ml, median (IQR)6584 ( )5917 ( ).18 Hb, g/dL median (IQR)14.5 ( )12.9 ( )<.0001 AST, UI/l, median (IQR)46 (31-79)37 (25-62)<.0001 ALT, UI/l, median (IQR)50 (31-83)36 (22-64)<.0001 Glucose, mg/dL, median (IQR)88 (81-80)85 (79-92)<.0001 anti hcv treatment**31 (1.4)9 (1.2).60

This finding suggests the pathogenic relevance of potential pathways to inflammatory process other than estrogens deprivation in HIV/HCV coinfected women

Key point for discussion… HCV-infected women represent an earlier enrolled population in ICONA Similar epidemiological profile among women and men Lower liver impairment at enrollment and similar liver disease progression High proportion of riba-containing regimens in women may reflect too advanced disease stage at treatment