Prospective, multicentre study of HIV/HCV co-infected patients following the first determination of decompensated cirrhosis or hepatocellular carcinoma

The prognosis for HIV infection has been improved through the development of antiretroviral multiple drug therapies. Although HIV infection is now better controlled, an increasing number of HIV/HCV co-infected patients are reaching the terminal stage of their viral liver disease. HIV/HCV co-infected patients experience a more rapid rate of fibrosis progression than HCV infected patients. Moreover, the complications of cirrhosis appear at an earlier stage in the context of HIV/HCV co-infection.

Why PRETHEVIC?

Principal aim

To describe the outcome and patient management of HIV/HCV co-infected patients following the first determination of decompensated cirrhosis or hepatocellular carcinoma.

• What percentage of these patients will be placed on the organ transplant waiting list ?
• What are the reasons for the non-registration on a transplant waiting list of HIV/HCV co-infected patients at this stage in their disease?
• What percentage of these patients will undergo transplantation?

Secondary aim

1) Identification des critères d’indication de transplantation hépatique chez les patients coinfectés VIH/VHC:

•  Quels patients faut-il transplanter ? Sur quels critères ? A quel moment ?
•  Le score de MELD, validé pour les patients monoinfectés par le VHC, est-il adapté pour les patients coinfectés VIH/VHC ?

En d’autres termes, quels sont les facteurs pronostiques de survie des patients co-infectés VIH/VHC au stade de cirrhose hépatique qui présentent une première décompensation de cirrhose ou un carcinome hépatocellulaire ?

2) Description de l’évolution des patients après transplantation hépatique.

Methodology

During this prospective multicentre study, only patients with the following criteria are included:

•   Aged 18 years or over.
  
•   HIV positive serology.
  
•   HCV positive serology.
  
•   Hepatic cirrhosis (histology clinical arguments - biological - radiological - non-invasive techniques)
  
•   Initial episode of clinical decompensation (ascites/digestive bleeding/hepato-renal syndrome/
  encephalopathy/non-obstructive jaundice) or a diagnosis of hepatocellular carcinoma within the past year.

The patients are being followed using the methods generally agreed upon by all hepatologists, infectious disease specialists, internists and transplant surgeons. Clinical, biological, radiological and endoscopic data are collected every three months. A serum and plasma collection will be realized at the inclusion of the patient and subsequently once a year.

Where is PRETHEVIC implemented ?

PRETHEVIC is a French national study which involves 53 sites including different hospital departments specialised in infectious diseases, hepato-gastroenterology, clinical immunology or internal medicine.

 

 

News about PRETHEVIC

Inclusion graph

 

 

PRETHEVIC in the media

• Le Quotidien du médecin (Wednesday 10 march 2010 - n°8725 - page 6)
• Protocoles 58 

Newsletters

• Newsletter n°18 - March 2012
  
• Newsletter n°17 - February 2012
  
• Newsletter n 16 - January 2012
  
• Newsletter n 15 - Nov-Dec. 2011
  
• Newsletter n°14 - October 2011
  
• Neswletter n°13 - September 2011
  
• Newsletter n°12 - August 2011
  
• Newsletter n°11 - July 2011
  
• Newsletter n°10 - June 2011
• Newsletter n°9 - May 2011
• Newsletter n°8 - April 2011
• Newsletter n°7 - March 2011
• Newsletter n°6 - February 2011
• Newsletter n°5 - January 2011
• Newsletter n° 4 - September 2010
• Newsletter n°3 - June 2010
• Newsletter n°2 - March 2010
• Newsletter n°1 - November 2009

Poster

Click to enlarge the poster

Contact us

• Coordinating investigator : Dr Jean-Charles Duclos-Vallée
• Co-coordinating investigator : Dr Elina Teicher
• Co-coordinating investigator : Pr Daniel Vittecoq
• Project manager : Marita Ostos, Tel : 01 45 59 67 78, Fax : 01 45 50 67 91
• Clinical resarch associate : Aurélie Belliard, Tel : 01 45 59 67 78, Fax : 01 45 50 67 91