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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,

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Presentation on theme: "QUALI DIFFERENZE IN RAPPORTO AL SESSO NELLA COINFEZIONE HCV/HIV? I DATI ITALIANI DALLA COORTE ICONA Antonella Cingolani Clinica Malattie Infettive, UCSC,"— Presentation transcript:

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

2 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

3 HBsAg and HCVAb positivity according to gender in 12.030 patients from ICONA Jun 2015 Report

4 HCVAb pos according to gender and mode of HIV transmission in 12.030 ICONA patients Jun 2015 Report

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6 Proportion of HCV genotypes for 1.321 HCV-RNA+ patients in ICONA Jun 2015 Report

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

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

9 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 (265-621)411 (227-601)0.05 Baseline CD4/CD8, median (IQR)0.54 (0.32-0.79)0.51 (0.27-0.78)0.12 On ART at baseline, n (%)39 (4.9)171 (9.1)0.003 HIV-RNA, log10 c/ml, median (IQR)4.2 (3.4-4.9) 0.98

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

11 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 (124-182)160 (132-190).002 Col HDL mg/dL, median (IQR)38 (30-47)45 (33-58)<.0001 INR, median (IQR)1.04 (0.99-1.13)1.01 (0.96-1.13).31 Albumina g/dL, median (IQR)4.2 (3.8-4.5)4.0 (3.7-4.3).10 Pche UI/ml, median (IQR)6584 (3871-8570)5917 (3503-7940).18 Hb, g/dL median (IQR)14.5 (13.2-15.4)12.9 (11.9-13.9)<.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

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

14 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

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