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Management Guidelines for the HCV/HIV Co- Infected Adult
Recommendations of a Multidisciplinary Expert Panel

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References

1. Health Canada. The Canadian guide to clinical preventative health care. The Canadian Task Force on the Periodic Health Examination, Minister of Supply and Services, Canada, 1994: xxxvii.

2. Health Canada. HIV and AIDS in Canada: Surveillance Report to December 31, 1999. Division of HIV/AIDS Surveillance, Bureau of HIV/AIDS, STD and TB, Laboratory Center for Disease Control. Minister of Public Works and Government Services Canada, 2000.

3. Health Canada, HIV/AIDS Epi-update - HIV AIDS among injection drug users in Canada. Laboratory Center for Disease Control, Ottawa, 2000.

4. Elliot CJ, Blanchard JF, Dinner K et al. The Winnipeg injection drug epidemiology (WIDE) study. Can J Inf Dis. 1999. 10 (Suppl B) C341.

5. Ford P, Pearson M, Stevenson T et al. HIV, hepatitis C and risk behavior in a Canadian medium security federal penitentiary. Q J Med. 2000; 93:113-19.

6. Enger C, Graham N, Peng Y et al. Survival from early, intermediate, and late stages of HIV infection. JAMA. 1996; 275: 1329-34.

7. Palella FJr, Delaney KM, Moorman AC et al. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. N Engl J Med. 1998;338:853-860.

8. Moore RD, Chaisson RE. Natural history of HIV infection in the era of combination antiretroviral therapy. AIDS 1999, 13:1933-42.

9. Hogg RS, Yip B, Kully C, Craib K, O'Shaughnessy MV, Schechter MT, Montaner JSG. Improved survival among HIV-infected patients after the initiation of triple-drug antiretroviral regimens. CMAJ 1999;160(5): 659-65.

10. Detels R, Munoz A, McFarlane G, Kingsley LA, Margolick JB, Giorgi J, Schrager LK, Phair JP, for the Multicenter AIDS cohort study investigators. Effectiveness of potent antiretroviral therapy on time to AIDS and death in men with known HIV infection duration. JAMA; 1998: 280:1497-1503.

11. Mocroft A, Vella S, Benfield TL, Chiesi A, Miller V, Gargalianos P, Monforte A, Yust I, Bruun JN, Phillips AN, Lundgren JD, for the EuroSIDA Study group. Changing patterns of mortality across Europe in patients infected with HIV-1. Lancet 1988; 352:1725-30

12. Gulick RM, Mellors JW, Havlir D et al. Treatment with indinavir, zidovudine, and lamivudine in adults with human immunodeficiency virus infection and prior antiretroviral therapy. N Engl J Med. 1997; 337:734-739.

13. Notermans DW, Jurriaans S, de Wolf F et al. Decrease of HIV-1 RNA levels in lymphoid tissue and peripheral blood during treatment with ritonavir, lamivudine and zidovudine. AIDS 1998; 12:167-73.

14. Montaner JSG, Reiss P, Cooper D et al. A randomized double-blind trial comparing combinations of nevirapine, didanosine, and zidovudine for HIV-infected patients, the INCAS trial. JAMA. 1998; 279:930-37.

15. Staszewski S, Morales-Ramirez J, Tashima K, et al. Efavirenz plus zidovudine and lamivudine, efavirenz plus indinavir and indinavir plus zidovudine and lamivudine in the treatment of HIV-1 infection in adults. New Engl J Med. 1999; 341:1865-73.

16. Staszewski S, Keiser P, Gathe J et al. Comparison of antiviral response with abacavir/combivir to indinavir/combivir in therapy-naïve adults at 48 weeks. Abstract 505. Presented at the 39 th Interscience Conference on Antimicrobial Agents and Chemotherapy. September 1999, San Francisco California.

17. Mehta S, Moore RD, Graham NHM. Potential factors affecting adherence with HIV therapy. AIDS. 1997; 11: 1665-70.

18. Schacker T, Little S, Connick E, Geghard-Mitchell K, Ahang Z, Krieger J, Pryor J, Havlir D, Wong JK, Richman D, Corey L, Haase A. Rapid accumulation of human immunodeficiency virus in lymphatic tissue reservoirs during acute and early HIV infection: Implications for timing of antiretroviral therapy. J Infect Dis. 2000: 181: 354-7.

19. Carpenter CC, Cooper DA, Fischl MA et al. Antiretroviral Therapy in Adults Updated Recommendations of the International AIDS Society- USA Panel. JAMA 2000; 283: 381-391.

20. Fauci AS, Bartlett JG, Goosby EP, Smith MD. Panel on clinical practices for treatment of HIV infection. Guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents: January 28, 2000. Federal register.

21. Rachlis AR, Zarowny DP for the Canadian HIV Trials Network Working Group. Guidelines for antiretroviral therapy for HIV infection. Can Med Assoc J. 1998;158:496-505.

22. Volberding P. Evidence-based recommendation on the management of HIV/AIDS: An Experts' Consensus meeting to develop treatment guidelines for developed nations. . J Acquir Immune Defic Syndr Hum Retrovirol, 1999, 1-17.

23. Deeks SG, Grant RM, Beatty GW, et al. Activity of a ritonavir plus saquinavir-containing regimen in patients with virologic evidence of indinavir or ritonavir failure. AIDS 1998;12:F97-F102.

24. Tebas P, Patick AK, Kane EM, et al. Virologic responses to a ritonavir-saquinavir- containing regimen in patients who had previously failed nelfinavir. AIDS 1999;13:F23-F28.

25. Thomas DL, Zenilman JM, Alter H et al. Sexual transmission of hepatitis C virus among patients attending sexually transmitted diseases clinics in Baltimore - an analysis of 309 sex partners. J Infect Dis. 1995; 171:768-75.

26. Gibb DM, Goodall RL, Dunn DT, Healy M, Neave P et al. Mother to child transmission of hepatitis C virus: evidence for preventable peripartum transmission. The Lancet 2000;356:904-907.

27. Remis R, Hogg R, Krahn M, Preiksaitis JK, Sherman M et al. Estimating the number of blood transfusion recipients infected by hepatitis C virus in Canada. 1960-85 and 1990-92. Report to Health Canada. June 1998.

28. Vogt M, Lang T, Frosner G, Klinger C, et al. Prevalence and clinical outcome of hepatitis C infection in children who underwent cardiac surgery before the implementation of blood-donor screening. N Engl J Med. 1999; 341:866-870.

29. Kenny-Walsh E. Clinical outcomes after hepatitis C infection from contaminated anti-D immune globulin. N Eng J Med. 1999; 340:1228-1233.

30 . Kiyosawa K, Tahaks E, Sodeyama T, Fumata S. Natural history of hepatitis C. Intervirology. 1994; 37:101-107.

31. Fattovich G, Giustina G, Degos F, Tremoloda F, Diodati G, Almasio P, Nevens F, Solinas A, Mura D, Brouwer JT, Thomas H, Njapoumic C, Casarin C, Bonetti P, Fushci P, Basho J, Tocca A, Bhalla A, Galassini R, Noventa F, Schalm SW. Morbidity and mortality in compensated cirrhosis type C: a retrospective follow-up study of 384 patients. Gastroenterology. 1997; 112(2):463-472.

32. Hu KQ, Tong MJ. The long term outcomes of patients with compensated hepatitis C virus-related cirrhosis and history of parental exposure in the United States. Hepatology. 1999; 29:1311-1316.

33. Poynard T, Bedossa P, Opolon P. Natural history of liver fibrosis progression in patients with chronic hepatitis C. Lancet. 1997; 349:825-832.

34. Benhamou Y, Bochet MD, Martino V, Charlotte F, Azria F, Coutellier A, Vidaud M, Bricaire F, Opolon P, Katlama C, Poynard J. Liver fibrosis progression in human immunodeficiency virus and hepatitis C virus coinfected patients. The MULTIVIRC group. Hepatology. 1999; 30:1054-1057.

35. www.hsc.on.ca/casl/ Canadian Consensus Conference on Viral Hepatitis 1999.

36. Bedossa P, Poynard T, for the METAVIR Cooperative Study Group. An algorithm for the grading of activity in chronic hepatitis C. Hepatology. 1996; 24: 289-93.

37. McHutchison J, Gordon S, Schiff E, et al. Interferon alfa 2b alone or in combination with ribavirin as initial treatment for chronic hepatitis C. N Engl J Med. 1998; 339:1485-1432.

38. Poynard T, Marcellin P, Lee S, et al. Randomized trial of interferon alpha 2b plus ribavirin for 48 weeks or for 24 weeks versus interferon alpha 2b plus placebo for 48 weeks for treatment of chronic infection with hepatitis C virus. Lancet. 1998; 352:1426-1432.

39. Davis G, Poynard T, Esteban-Mur R, Albrecht J et al. Durability of viral response to interferon alone or in combination with oral ribavirin in patients with chronic hepatitis C. Hepatology 1999; 30:570A.

40. Marcellin P, Boyer N, Gervais A et al. Long-term histologic improvement and loss of detectable intrahepatic HCV RNA in patients with chronic hepatitis C and sustained response to interferon-? therapy. Ann Intern Med 1997;127:875-881.

41. Camma C, DiMarco V, Lo Iacono O et al. Long-term course of interferon treated chronic hepatitis C. J Hepatol 1998;38:531-537.

42. Lau D, Kleiner DE, Ghany MG, Park Y, Schmid P et al. 10 year follow-up after interferon-? therapy for chronic hepatitis C. Hepatology 1998;28:1121-1127.

43. Yoshida H, Shiratori Y, Moriyami M et al. Interferon therapy reduces the risk of hepatocellular carcinoma: national surveillance program of cirrhotic and non-cirrhotic patients with chronic hepatitis C in Japan. Ann Intern Med 1999;131:174-181.

44. Bonkovsky H, Woolley M the Consensus Interferon Study Group. Reduction of health-related quality of life in chronic hepatitis C and improvement with Interferon therapy. Hepatology 1999;29:264-270.

45. Ware JE, Bayliss M, Mannocchia M, Davis G, the International Hepatitis Interventional Therapy Group. Health related quality of life in chronic hepatitis C:impact of disease and treatment response. Hepatology 1999;30:550-555.

46. Sherman KE, Freeman S, Harrison S, Andron L. Prevalence of antibody to hepatitis C virus in patients infected with the human immunodeficiency virus. J Infect Dis. 1991; 163:414-415.

47. Martin P, Di Bisceglie AM, Kassianides C, Lisker-Melman M, Hoofnagle JH. Rapidly progressive non-A, non-B hepatitis in patients with human immunodeficiency virus infection. Gastroenterology. 1989; 97:1559-1561.

48. Sanchez-Quijano A, Andreu J, Gavilan F, Luque F, Abad MA, Soto B, Munoz J, Aznar JM, Leal M, Lissen E. Influence of human immunodeficiency virus type I infection on natural course of chronic parenterally acquired hepatitis C. Eur J Clin Microbial Infect Dis. 1995; 14:949-953.

49. Soto B, Sanchez-Quijano A, Rodrigo L, del Olmo JA, Garcia Bengoechea M, Hernandez-Quereo J, Rey C, Abad MA, Rodriguez M, Sales Gilabert M, Gonzalez F, Miron P, Caruz A, Relimpio F, Torrenteras R, Leal M, Lissen E. Human immunodeficiency virus infection modifies the natural history of chronic parenterally-acquired hepatitis C with an unusually rapid progression to cirrhosis. J Hepatology. 1997; 26(1):1-5.

50. Darby S, Ewart D, Giangrande P, Spooner R, Rizza C, Dusheiko G, Lee C, Ludlam C, Preston F. Mortality from liver cancer and liver disease in haemophiliac men and boys in UK given blood products contaminated with hepatitis C. Lancet. 1997; 350:1425-1431.

51. Colin JF, Cuzais-Hatem D, Loriot MA, Martinot-Peignoux M, Pham BW, Auperin A, Degott C, Benhamou JP, Erlinger S, Valla D, Marcellin P. Influence of human immunodeficiency virus infectin on chronic hepatitis B in homosexual men. Hepatology. 1999; 29(4):1306-1310.

52. Allory Y, Charlotte F, Benhamou Y, Opolon P, LeCarpentire Y, Poynard T. Impact of human immunodeficiency virus infection on the histological features of chronic hepatitis C: A case-control study. The MULTIVIRC group. Human Pathol. 2000; 31:69-74.

53. Romeo R, Rumi MG, Donato MF, Cargnel MA, Vigano P, Mondelli M, Cesana B. Hepatitis C is more severe in drug users with human immunodeficiency virus infection. J Viral Hepatitis. 2000; 7:297-301.

54. Staples CT, Rimland D, Dudas D. Hepatitis C in the Human Immunodeficiency Virus Atlanta Veterans Affairs Medical Center cohort study (HAVACS): the effect of coinfection on survival. Clin Infect Dis. 1999; 29:150-154.

55. Spinetti A, Puito M, Donato F et al. Increase of liver related in hospital mortality in a cohort of Italian seropositives after introduction of HAART: role of hepatitis virus coinfections. Abstract TuPe3184, Presented at the XIII International AIDS Conference, Durban South Africa, July 2000.

56. Sulkowski MS, Thomas DL, Chaisson RE, Moore RD. Hepatotoxicity associated with antiretroviral therapy in adults infected with human immunodeficiency virus and the role of hepatitis C or B virus infection. JAMA. 2000; 283;74-79.

57. Hauser PM, Blanc DS, Bille J, Nahimana A, Francioli P. The impact of co- infection with hepatitis C virus and HIV on the tolerability of antiretroviral therapy. J of Acquir Immune Defic Syndr. 2000; 14:463-464.

58. Rutschmann OT, Negro F, Hirschel B, Hadengue A, Anwar D, Perrin LH. Impact of treatment with human immunodeficiency virus (HIV) protease inhibitors on hepatitis C viremia in patients coinfected with HIV. J Infect Dis. 1998; 177:783-785.

59. Perez-Olmeda M, Garcia-Saramego J, Soraino V. Hepatitis C viraemia in HIV-HCV co-infected patients having immune restoration with highly active antiretroviral therapy. AIDS. 2000; 14: 212.

60. Moatti JP, Carrieri MP, Spire B, Gastaut JA, Cassuto JP, Moreau J. Adherence to HAART in French HIV-infected injecting drug users: the contribution of buprenorphine drug maintenance treatment. The Manif. 2000 study group. AIDS. 2000; 14:151-5.

61. Loguercio C, Di Pierro M, Di Marino MP, et al. Drinking habits of subjects with hepatitis C virus-related chronic liver disease: prevalence and effect on clinical, virological and pathological aspects. Alcohol. 2000; 35:296-301

62. Khan KN, Yatsuhashi H. Effect of alcohol consumption on the progression of hepatitis C virus infection and risk of hepatocellular carcinoma in Japanese patients . Alcohol 2000; 35:286-95

63. Thomas DL, Astemborski J, Rai RM, et al. The natural history of hepatitis C virus infection: host, viral, and environmental factors. JAMA 2000;284:450-6.

64. Thio CL, Nolt KR, Astemborski J, Vlahov D, Nelson KE et al. Screening for hepatitis C virus in human immunodeficiency virus infected individuals. J. Clin Microbial 2000;38:575-7.

65. Expert working group on HIV testing. Counseling guidelines for HIV testing. Ottawa: 1995, Canadian Medical Association.

66. Sees KL, Delucchi KL, Masson C, et al. Methadone maintenance vs 180-day psychosocially enriched detoxification for treatment of opioid dependence: a randomized controlled trial JAMA. 2000; 283:1303-10.

67. U.S. Public Health Service and Infectious Diseases Society of America. 1999 USPHS/IDSA guidelines for the prevention of opportunistic infections in persons infected with Human Immunodeficiency Virus. MMWR, 1999: 48: RR-10, 1-66.

68. Reichard O, Yun ZB, Sonnerborg A, Weiland O. Hepatitis C viral RNA titers in serum prior to, during, and after oral treatment with ribavirin for chronic hepatitis C. J Med Virol. 1993; 41(2):99-102.

69. Zeuzem S, Feinman SV, Rasenack, Heathcote EJ, Lay MY, Gane E, Grady JO, Reichen HJ, Brunda MJ. Evaluation of the safety and efficacy of once-weekly PEG/interferon alfa-2a (Pegasys?) for chronic hepatitis C. A multinational randomized study. New Engl J Med. ( In press 2000)

70. Heathcote EJ, Shiffman ML, Cooksley G, Dusheiko GM, Lee SS, Balart L, Reindollar R, Reddy R, Wright T, Dephamphilis J. Multinational evaluation of the efficacy and safety of once-weekly PEGinterferon ?-2a (PEG-IFN) in patients with chronic hepatitis. C (CHC) with compensated cirrhosis. New Engl J Med (In press, 2000)

71. Glue P, Rouzier-Panis R. Raffanel C, Sabo R, Gupta S et al. A dose ranging study of pegylated interferon Alfa-2b and ribavirin in chronic hepatitis C. Hepatology 2000;32:647-653.

72. Heathcote EJ. Issues regarding the antiviral therapy of subjects with chonic hepatitis C. Seminars in Liver Disease.2000, 20:185-99.

73. McCormick SE, Goodman ZP, Maydonovich CL, Sjorgren MH. Evaluation of liver histology, ALT elevation and HCV RNA titre in patients with chronic hepatitis C. Am J Gastroenterol. 1996; 91: 1516-22.

74. Proti C, Stati T, Magcini A. Serum HCV RNA titre does not predict the severity of liver damage in HCV cases with normal aminotransferase levels. Liver. 1999. 19: 104-9.

75. Sharry MG, Chau TM, Sandoz-Pescador R, Urdea M, Lok AS. Correlation between serum HCV RNA and aminotransferase levels in patients with chronic HCV infection. Dig Dis Sci. 1996. 41: 2213-8.

76. Luo JC, Hwang SJ., Lai CR, Lu CL, Li CP, Tsay SH, Wu JC, Chang FY, Lee SD. Relationship between serum aminotransferase levels, liver histology and virological status in patients with chronic hepatitis C in Taiwan. J. Gastroenterol Hepatol. 1998.13: 685-90.

77. Schneiderman D, Arenson D, Cello J, Margaretten W, Weber T. Hepatic disease in patients with the acquired immune deficiency syndrome. Hepatology 1987;7:925-30.

78. Poles M, Dieterich D, Schwarz E, Weinshel E, Lew E, Lew R, Scholes J. Liver biopsy findings in 501 patients infected with human immunodeficiency virus (HIV). J Acquir Immune Defic Syndr Hum Retrovirol 1996;11:170-7.

79. Aledort LM, Levine PH, Hilgartner M, Blatt P, Spero JA, Goldberg JD, Bianchi L, Desmet V, Scheuer P, Popper H, Berk PD. A study of liver biopsies and liver diseases among hemophiliacs. Blood 1985;66:367-
72.

80. Preston FE, Dusheiko G, Lee GA, Ludlam CA. Giangrande PLF. Guidelines on the diagnosis and management of chronic liver disease in hemophilia. Haemophilia 1995;1:42-4.

81. Wong VS, Baglin T, Beacham E, Wight DDG, Petrik J, Alexander GJM. The role of liver biopsy in haemophiliacs infected with the hepatitis C virus. Br J Haematol 1997;97:343-7.

82. Wong JB, Poynard T, Ling MH, Albrecht JK, Pauker SG. Cost effectiveness of 24 or 48 weeks of interferon treatment alpha-2b alone or with ribavirin as initial treatment of chronic hepatitis C. Am J Gastro. 2000; 95: 1524-30.

83. Koff RS. Outcomes of costs of care in hepatitis C: combination therapy scores again. Am J Gastro. 2000; 95(6):1392-3.

84. Garcia-Tsao G, Boyer J. Outpatient liver biopsy: How safe is it? Ann Intern Med. 1993; 118: 150-53.

85. Piccinino F, Sagnelli E, Pasquale G, Giusti G et al. Complications following percutaneous liver biopsy: A multicenter retrospective study on 68,276 biopsies. J Hepatol 1986; 2: 165-73.

86. Weiss K. Safety profile of interferon alpha therapy. Semin Oncol.1998. 25(1 Suppl): 9-13.

87. Maddrey W. Safety of combination interferon alfa-2b/ribavirin therapy in chronic hepatitis C-relapsed and treatment naïve patients. Semin. Liver Dis. 1999; 19:67-75.

88. Boyer N, Marcellin P, Degott C, et al. Recombinant interferon alpha for chronic hepatitis C in patients positive for antibody to human immunodeficiency virus. J Infect Dis. 1992; 165: 723-6.

89. Marriott E, Navas S, del Romero J, et al. Treatment with recombinant alpha interferon of chronic hepatitis C in anti-HIV positive patients. J Med Virol. 1993; 40: 107-111.

90. Soriano V, Garcia-Samaniego J, Bravo R, Gonazalez J, Castro A, Castilla J, Martinez-Odriozola P, Comenero M, Carballo E, Suarez D, Rodriguez-Pinero FJ, Moreno A, del Romero J, Pederira J, Gonzalez-Lahoz J, and the Hepatitis-HIV Spanish Study Group. Interferon ? for the treatment of chronic hepatitis C in patients infected with human immunodeficiency virus. Clin Infect Dis. 1996; 23: 585-91.

91. Laundau A, Batisse D, Van Huyen JPD, Piketty C, Bloch F, Pialoux G, Belec L, Petite JP, Weiss L, Kazatchkine MD. Efficacy and safety of combination therapy with interferon-alpha-2b and ribavirin for chronic hepatitis C in HIV-infected patients. AIDS. 2000; 14: 839-44.

92. Causse X, Payen JL, Izopet J, Babany G, Saint Marc Girardin MF and the French Multicener Study Group. Does HIV-infection influence the response of chronic hepatitis C to interferon treatment? A French Multicenter prospective study. J Hepatol 2000; 32: 1003-10.

93. Ikeda K, Saitoh S, Suzuki Y, Kobayashi M, et al. Disease progression and hepatocellular carcinogenesis in patients with chronic viral hepatitis: A prospective observation of 2215 patients. J Hepatol. 1998; 23:1334-1340

94. Yano M, Kumada H, Kage M, Ikeda K, et al. The long-term pathological evolution of chronic hepatitis C. Hepatology. 1996; 23:1334-1340.

95. Schiffman M, Hofmann C, Contos M, Luketic V, Sanyal A, Sterling R, Ferreira-Gonzalez A, et al. A randomized controlled trial of maintenance hepatitis interferon therapy for patients with chronic C virus and persistent viremia. Gastroenterology. 1999; 117:1164-1172.

96. Baba M, Pauwels R, Balzarini J, Herewijn P, de Clercq E, Desmyter J. Ribavirin antagonizes inhibitory effects of pyrimidine 2'3'-dideoxynucleosides but enhances inhibitory effects of purine 2'3'-dideoxynucleosides on replication of human immunodeficiency virus infection in vitro. Antimicrob Agents Chemother. 1987. 31: 1613-17.

97. Vogt MW, Hartshorn KL, Furman PA et al. Ribavirin antagonizes the effect of azithymidine on HIV replication. Science. 1987; 235: 1376-1379.

98. Zydelberg H, Benhamou Y, Lagneaux JL, Landau A, Chaix ML et al. Safety and efficacy of interferon-ribavirin combination therapy in HCV-HIV coinfected subjects: an early report. Gut 2000;47:694-697.

99. Brosgart C, Mitchell TF, Coleman RL, Dyner T, Stephenson KE, Abrams DI. Clinical experience and choice of drug therapy for Human Immunodeficiency virus disease. Clin Infect Dis. 1999; 14-22.

100. Volberding PA. Improving the outcomes of care for patients with human immunodeficiency virus infection. N Engl J Med. 1996; 334: 729-31.

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