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Article Dans Une Revue Alimentary Pharmacology and Therapeutics Année : 2017

The negative impact of HBV/HCV coinfection on cirrhosis and its consequences

1 Service d'hépatologie médicale [CHU Cochin]
2 Inserm U1223 - Physiopathologie du système immunitaire
3 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
4 Epidémiologie, Systèmes d'Information, Modélisation
5 ANRS France Recherche Nord & sud Sida-hiv hépatites
6 Service d'hépatologie et de gastroentérologie [Hôpital Saint-Joseph - Marseille]
7 UPMC - Université Pierre et Marie Curie - Paris 6
8 Sorbonne Universités (COMUE)
9 IHU ICAN - Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière]
10 SESSTIM - U912 INSERM - Aix Marseille Univ - IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale
11 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
12 Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB)
13 Santé publique France - French National Public Health Agency [Saint-Maurice, France]
14 Service d’Hépatologie [Hôpital Beaujon]
15 Inserm U955 - Molecular virology and immunology – Physiopathology and therapeutic of chronic viral hepatitis (Team 18)
16 Hôpital Jean Verdier [AP-HP]
17 U1162 - Génomique Fonctionnelle des Tumeurs Solides
18 Service d'Hépatologie et de Gastroentérologie [Lyon]
19 CHU Pitié-Salpêtrière [AP-HP]
20 BaRITOn - Bordeaux Research In Translational Oncology [Bordeaux]
21 Service des Maladies de l'Appareil Digestif et de la Nutrition [CHRU Lille]
22 HUG - Geneva University Hospital
23 Département d'Hépato-Gastroentérologie et de Transplantation Hépatique [CHU Saint-Eloi]
24 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
25 BPH - Bordeaux population health
26 INSERM U823 - Institut d'oncologie/développement Albert Bonniot de Grenoble
Patrice Cacoub
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  • PersonId : 923051
Francesco Negro
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  • PersonId : 911135
Linda Wittkop
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  • PersonId : 859302

Résumé

BACKGROUND: Hepatitis B virus (HBV)/hepatitis C virus (HCV) confection has been rarely studied in nonasian series. AIM: To compare the characteristics of HBV/HCV coinfected patients to those of HBV- or HCV-monoinfected patients in the ANRS CO22 HEPATHER cohort study. PATIENTS AND METHODS: Of the 20 936 included patients, 95 had HBV/HCV coinfection (hepatitis B surface antigen, anti-HCV antibody and HCV RNA positive) and were matched with 375 HBV- and 380 HCV-monoinfected patients on age, gender and time since HBV or HCV diagnosis. RESULTS: F3-F4 fibrosis was more frequent in coinfected patients (58%) than in HBV- (32%, P \textless .0001), but similar in HCV-monoinfected patients (52%, P = .3142). Decompensated cirrhosis was more frequent in coinfected patients (11%) than in HBV- (2%, P = .0002) or HCV- (4%, P = .0275) monoinfected patients. Past excessive alcohol use was more frequent in coinfected patients (26%) than in HBV (12%, P = .0011), but similar in HCV monoinfected patients (32%, P = .2868). Coinfected patients had a higher proportion with arterial hypertension (42%) than HBV- (26%) or HCV-monoinfected patients (25%) (P \textless .003). Multivariable analysis confirmed the association between F3-F4 fibrosis and HCV infection in HBV-infected patients (OR = 3.84, 95% CI 1.99-7.43) and the association between decompensated cirrhosis and coinfection in HBV infected (OR = 5.58, 95% CI 1.42-22.0) or HCV infected patients (OR = 3.02, 95% CI 1.22-7.44). CONCLUSIONS: HCV coinfection harmfully affects liver fibrosis in HBV patients, while decompensated cirrhosis is increased in coinfected patients compared with HBV- or HCV-monoinfected patients. HCV treatment is as safe and effective in coinfected as monoinfected patients and should be considered following the same rules as HCV monoinfected patients.

Dates et versions

hal-01743648 , version 1 (26-03-2018)

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Stanislas Pol, Georges Haour, Hélène Fontaine, Céline Dorival, Ventzislava Petrov‐sanchez, et al.. The negative impact of HBV/HCV coinfection on cirrhosis and its consequences. Alimentary Pharmacology and Therapeutics, 2017, 46 (11-12), pp.1054--1060. ⟨10.1111/apt.14352⟩. ⟨hal-01743648⟩
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