Direct-Acting Antiviral Initiation Among People With Hepatitis C Virus (HCV) and HIV on Antiretroviral Therapy in the United States and Canada: Factors Driving the HCV Treatment Gap.

Background: People with human immunodeficiency virus (HIV; PWH) are at increased risk of hepatitis C virus (HCV) coinfection and experiencing negative clinical outcomes. We evaluated direct-acting antiviral (DAA) initiation among PWH with HCV to identify factors associated with initiation.

Methods: US and Canadian PWH ≥18 years with a detectable HCV RNA in the North American AIDS Cohort Collaboration on Research and Design were followed up from the latest of first detectable HCV viremia, antiretroviral therapy initiation, enrollment date, or 1 January 2014 until the first of DAA prescription, clearance of HCV viremia, loss to follow-up, death, or 31 December 2021.

VH3810109 Efficacy, Safety, Pharmacokinetics, and Incidence of Anti-drug Antibodies in Adults With HIV-1 Naive to Antiretroviral Therapy: BANNER Study Results.

Background: VH3810109 (N6LS) is a CD4-binding site antibody with broad and potent neutralizing activity in vitro. Here, we present efficacy, safety, and pharmacokinetic results from the phase 2a BANNER study in people with HIV-1.

Methods: BANNER was a randomized, open-label, 2-part, multicenter study of N6LS in adults naive to antiretroviral therapy (ART) with HIV-1 RNA ≥5000 copies/mL.

National hepatitis B and C estimates for 2021: Measuring Canada's progress towards eliminating viral hepatitis as a public health concern.

Background: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are major causes of morbidity and mortality worldwide. Measuring the epidemiological burden of HCV and HBV in Canada is essential to measure progress towards global elimination targets and to ultimately eliminate viral hepatitis as a public health concern.

Objective: This study aimed to provide the first national estimates of HBV prevalence and unawareness, and to update estimates of HCV incidence, prevalence, and unawareness in the general population and key populations in Canada for 2021.

Progress Toward Hepatitis C Virus Elimination among People Living with HIV-Hepatitis C Virus Coinfection in Canada.

Background: Direct-acting antivirals (DAAs) for hepatitis C virus (HCV) were approved in Canada in 2013. By 2018, treatment restrictions had been lifted in all provinces, making DAAs universally accessible. Here, we aim to assess progress toward HCV elimination in the DAA era (2014-2022) within the Canadian Co-infection Cohort.

Predicting Fatal Drug Poisoning Among People Living with HIV-HCV Co-Infection.

Background: Drug poisoning (overdose) is a public health crisis, particularly among people living with HIV and hepatitis C (HCV) co-infection. Identifying potential predictors of drug poisoning could help decrease drug-related deaths.

Methods: Data from the Canadian Co-infection Cohort were used to predict death due to drug poisoning within 6 months of a cohort visit.

Clinical Practice Guideline-Supported Administration of Monoclonal Antibody Therapy for High-Risk Patients with COVID-19: Experience of a Quaternary Care Centre.

Background: Immunocompromised patients remain at risk of progression to severe COVID-19 disease.

Methods: We describe clinical COVID-19-related outcomes after administration of anti-SARS-CoV-2 monoclonal antibodies (mAb) following institutional clinical practice guidelines (CPGs) in 205 high-risk patients between November 2021 and April 2022 at a Canadian quaternary care centre.

Results: Median patient age was 59 years; 102 (50%) were female.

A pre-post study of the impact of a multidisciplinary model of care on linkage to hepatitis C care following release from prison: The Beyond Prison Walls study.

Background: Many people are released from prison with untreated hepatitis C virus (HCV) and fail to link to care due to competing priorities. We compared linkage to HCV care among individuals who engaged in a multidisciplinary model of care versus in standard of care, and examined factors associated with linkage to care.

Methods: We conducted a prospective, quasi-experimental pre-post study in Quebec's largest provincial prison.

Evaluation of the virtual care experience for persons in prospective cohorts with HIV during the COVID pandemic.

The COVID pandemic necessitated shifting to virtual care. Our aim was to describe, and identify the challenges and satisfaction with the virtual care experience of a subset of participants from two established Canadian Trials Network (CTN) cohorts: CTN 222 (HIV/HCV coinfection) and CTN 314: CHANGE HIV (Correlates of Healthy Aging in geriatric HIV infection) - persons > 65 years age. We hypothesized that vulnerable populations could face challenges with virtual care related to age, mental health or drug addiction.

Changes in the prevalence of non-AIDS conditions among hospitalized persons with HIV in the United States and Canada, 2008-2018.

Background: Hospitalization causes among persons with HIV (PWH) have shifted to non-AIDS conditions, but the complete disease profile of hospitalized PWH has not been well described. To inform hospitalization and readmission prevention efforts, we examined non-AIDS disease prevalence among PWH hospitalized in four US and one Canadian cohorts.

Methods: Among PWH with ≥1 hospitalization from 2008 to 2018, we used log-binomial regression with generalized estimating equations to estimate trends in the annual prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), hypertension, hyperlipidemia, diabetes mellitus, chronic kidney disease stage ≥3 (CKD), and multimorbidity (≥2 and ≥3 conditions), defined using longitudinal diagnosis, medication, and laboratory data.

Liver Fibrosis Regression in People Living With HIV After Successful Treatment for Hepatitis C.

Background: Successful treatment of hepatitis C virus (HCV) can lead to liver fibrosis regression. It is not known who will experience fibrosis regression or how quickly it will occur.

Methods: We modeled transient elastography (TE) measurements from 1470 HIV-HCV coinfected participants followed in cohorts contributing data to InCHEHC, an international collaboration.

Time to direct-acting antiviral initiation and liver-related events in people with HIV and hepatitis C virus.

Objective: People with HIV-hepatitis C virus (HCV) co-infection need antiretroviral treatment (ART) to suppress HIV and direct-acting antivirals (DAAs) to cure HCV. ART is typically prioritized, but delays in DAA initiation may increase the risk of liver-related events and HCV transmission to others.

Design: Target trial emulation with observational data collected in routine clinical practice from a collaboration of cohorts from Europe and North America.

Effect of depressive symptoms on health services utilization in the HIV and hepatitis C co-infected population in Canada.

Depression is common among people living with HCV and HIV, which contributes to health services utilization (HSU). It is unknown whether successful HCV treatment affects this. We examined depressive symptoms and HSU in people co-infected with HIV-HCV and their association with sustained virologic response (SVR) during the direct-acting antiviral era.

Unsuccessful Direct Acting Antiviral Hepatitis C Treatment Among People With HIV: Findings From an International Cohort.

Background: Historically, hepatitis C virus (HCV) was difficult to treat among people with HIV. However, treatment with direct-acting antivirals (DAAs) results in 90%-95% of people being cured. There is a need to understand why a proportion of people are not cured.

Implementing a Patient Portal for the Remote Follow-Up of Self-Isolating Patients With COVID-19 Infection Through Patient and Stakeholder Engagement (the Opal-COVID Study): Mixed Methods Pilot Study.

Background: The COVID-19 pandemic was an unprecedent challenge to public health systems, with 95% of cases in Quebec sent home for self-isolation. To ensure continuous care, we implemented an intervention supported by a patient portal (Opal) to remotely monitor at-home patients with COVID-19 via daily self-reports of symptoms, vital signs, and mental health that were reviewed by health care professionals.

Objective: We describe the intervention's implementation, focusing on the (1) process; (2) outcomes, including feasibility, fidelity, acceptability, usability, and perceived response burden; and (3) barriers and facilitators encountered by stakeholders.

Perceived patient navigator services and characteristics to address barriers to linkage to hepatitis C care among people released from provincial prison in Quebec, Canada.

Background: Patient navigation increases linkage to hepatitis C virus (HCV) care following release from prison; however, little is known about the services patient navigators should provide to maximize linkage to care. We aimed to identify perceived barriers and facilitators to linkage to HCV care post-release, and to determine patient navigator services and characteristics best suited to address barriers to linkage to care among people released from prison.

Methods: Ten semi-structured interviews were conducted with adult (age ≥18 years) men living with chronic HCV, released from the largest Quebec provincial prison, and linked to HCV care by a patient navigator.

Changes in Hepatic Steatosis Before and After Direct-Acting Antiviral Treatment in People With HIV and Hepatitis C Coinfection.

Background: Both human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections increase the risk of hepatic steatosis (HS), which in turn contribute to the severity and progression of liver disease. Direct-acting antivirals (DAAs) can cure HCV but whether they reduce HS is unclear.

Methods: HS was assessed using the controlled attenuation parameter (CAP) and the Hepatic Steatosis Index (HSI) in participants coinfected with HIV and HCV from the Canadian Coinfection Cohort.

Material deprivation is associated with liver stiffness and liver-related outcomes in people with HIV.

Background: Socioeconomic status (SES) is a driver of health disparities and chronic diseases. People with HIV (PWH) are at risk for chronic liver diseases. We evaluated the association between low SES and hepatic outcomes in PWH.

Frequent Disengagement and Subsequent Mortality Among People With HIV and Hepatitis C in Canada: A Prospective Cohort Study.

Background: The cascade of care, commonly used to assess HIV and hepatitis C (HCV) health service delivery, has limitations in capturing the complexity of individuals' engagement patterns. This study examines the dynamic nature of engagement and mortality trajectories among people with HIV and HCV.

Methods: We used data from the Canadian HIV-HCV Co-Infection Cohort, which prospectively follows 2098 participants from 18 centers biannually.

Non-AIDS-defining comorbidities impact health related quality of life among older adults living with HIV.

Introduction: The life expectancy of people living with HIV receiving effective combination antiretroviral therapy is approaching that of the general population and non AIDS-defining age-related comorbidities are becoming of greater concern. In order to support healthy aging of this population, we set out to explore the association between multimorbidity (defined as presence of 2 or more non AIDS-defining comorbidities) and quality of life (QoL).

Methods: We performed a cross-sectional analysis using data from the Correlates of Healthy Aging in Geriatric HIV (CHANGE HIV) study, a Canadian cohort of people living with HIV age 65  years and older.