HCV/HIV Coinfection: Antiviral Therapy and Fibrosis

Study Overview
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Brief Summary
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The chief purpose of this research is to understand how antiretroviral therapy (ART) affects progression of liver disease in persons co-infected with HIV and hepatitis C virus (HCV). The investigators study liver disease progression in a cohort of dually infected persons according to the success of ART.

Detailed Description
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Enrolled subjects will complete questionnaires concerning health status, lifestyle, and alcohol/drug use. Participants will undergo liver elastography every 6-12 months.

Official Title
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HCV/HIV Coinfection: Antiviral Therapy and Fibrosis

Conditions
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HIV Infection, Hepatitis C

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Co-Infected Arm Subject must be an HIV/HCV co-infected adult with HIV infection diagnosed by antibody testing and chronic HCV infection diagnosed by reactive HCV antibody and detectable plasma HCV RNA. Subject must receive medical care at the JHU HIV clinic or through the Viral Hepatitis Center. Subjects previously enrolled in the study cohort, but not currently receiving care in the Moore Clinic, may continue in the study. Females of childbearing potential must be willing to undergo a urine or serum pregnancy test. Subject must be able to provide informed written consent. Control Arm Subject must have or be at risk of having medical conditions that increase the risk of liver disease. These include, but are not limited to, HIV mono-infection, HCV mono-infection, Hepatitis B infection, alcohol addiction, and/or non-alcoholic steatohepatitis. Females of childbearing potential must be willing to undergo a urine or serum pregnancy test. Subject must be able to provide informed written consent. Exclusion Criteria: To avoid risks associated with ionizing radiation, female subjects may not be pregnant or breast feeding at the time of DEXA scanning. To avoid unknown risks to the fetus, female subjects may not be pregnant at the time of liver biopsy or FibroScan. To avoid interference with the DEXA scan, the subject may not have undergone a nuclear medicine exam with the past week and/or may not have undergone an x-ray procedure with contrast solution within the past 72 hours. To avoid unknown risks, subjects with an implanted cardiac device such as a defibrillator or pacemaker may not undergo FibroScan.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 99 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Main cohort<br>Adults infected with both HIV and Hepatitis C | |
| Control Group<br>Adults at risk for liver disease, but not infected with both HIV and Hepatitis C | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Fibrosis stage | Liver histologic fibrosis stage (Ishak 0 - 6) | up to 15 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Body composition | Body composition measurements, derived from DEXA | up to 15 years | 
| Liver stiffness | Liver stiffness, derived from liver elastography | up to 15 years | 
| Serum markers | Serum levels of various chemical markers | up to 15 years | 
| Liver histology | Liver histology as described by a pathologist | up to 15 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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HIV, Human immunodeficiency virus, Acquired Immune Deficiency Syndrome Virus, AIDS Virus, Immunodeficiency Virus, Human, Virus, Human Immunodeficiency, Hepatitis C, Hepatitis C, chronic, Hepatitis C virus, Hepatitis C antibodies, Hepatitis C antigens