1. UKCHIC Richard Gilson on behalf of the Hepatitis Subgroup Progress update July 2010 UK CHIC

2. Hepatitis subgroup UK CHIC Main focus – HBV/HCV co-infection Data available Liver function testsLiver function tests HBV/HCV serologyHBV/HCV serology HBV/HCV viral loadHBV/HCV viral load HBV treatment if this is a HAART componentHBV treatment if this is a HAART component Limited cause of death dataLimited cause of death data

3. What have we done already UK CHIC HCV testing, prevalence, and impact on HAART outcomeHCV testing, prevalence, and impact on HAART outcome (Published Jo Turner et al – JVH advance online) How can ALT flares best be definedHow can ALT flares best be defined (Published Loveleen Bansi et al – JAIDS)

4. Research questions UK CHIC 1.What is the effect of hepatitis co-infection on HAART outcomes immunological and virological response drug toxicity rate of treatment discontinuation response to more potent therapies? 2.What is the impact of hepatitis co-infection on mortality and is this related to for eg. genotype? 3.What is the impact of acute HCV infection on the progression of HIV disease and response to HAART? 4.What are the associations between HCV co-infection, ALT/AST levels and lipid profiles? 5.Does HBV treatment have an impact on HIV resistance development? 6.Who requires a liver transplant and what is the outcome?

5. Challenges – additional data UK CHIC OptionsOptions – Add data items to routine UK CHIC data download – Set up bespoke data collection Additional data itemsAdditional data items –AFP –HCV/HBV genotype –Resistance data – link with Resistance Database –HBV/HCV treatment history –Other drugs – eg EPO/GCSF/TB Rx –Clinical – liver disease; alcohol –Other investigations – USS; liver biopsy; Fibroscan

6. Plan UK CHIC Agree data itemsAgree data items Additional data collection – funding applicationAdditional data collection – funding application Add data items to next data downloadAdd data items to next data download Continue analyses with available dataContinue analyses with available data

7. Research questions UK CHIC 1.What is the effect of hepatitis co-infection on HAART outcomes immunological and virological response drug toxicity rate of treatment discontinuation response to more potent therapies? 2.What is the impact of hepatitis co-infection on mortality and is this related to for eg. genotype? 3.What is the impact of acute HCV infection on the progression of HIV disease and response to HAART? 4.What are the associations between HCV co-infection, ALT/AST levels and lipid profiles? 5.Does HBV treatment have an impact on HIV resistance development? 6.Who requires a liver transplant and what is the outcome?

8. Research questions UK CHIC 1.What is the effect of hepatitis co-infection on HAART outcomes immunological and virological response drug toxicity rate of treatment discontinuation response to more potent therapies? 2.What is the impact of hepatitis co-infection on mortality and is this related to for eg. genotype? 3.What is the impact of acute HCV infection on the progression of HIV disease and response to HAART? 4.What are the associations between HCV co-infection, ALT/AST levels and lipid profiles? 5.Does HBV treatment have an impact on HIV resistance development? 6.Who requires a liver transplant and what is the outcome?

9. Research questions UK CHIC 1.What is the effect of hepatitis co-infection on HAART outcomes immunological and virological response drug toxicity rate of treatment discontinuation response to more potent therapies? 2.What is the impact of hepatitis co-infection on mortality and is this related to for eg. genotype? 3.What is the impact of acute HCV infection on the progression of HIV disease and response to HAART? 4.What are the associations between HCV co-infection, ALT/AST levels and lipid profiles? 5.Does HBV treatment have an impact on HIV resistance development? 6.Who requires a liver transplant and what is the outcome?

10. Research questions UK CHIC 1.What is the effect of hepatitis co-infection on HAART outcomes immunological and virological response drug toxicity rate of treatment discontinuation response to more potent therapies? 2.What is the impact of hepatitis co-infection on mortality and is this related to for eg. genotype? 3.What is the impact of acute HCV infection on the progression of HIV disease and response to HAART? 4.What are the associations between HCV co-infection, ALT/AST levels and lipid profiles? 5.Does HBV treatment have an impact on HIV resistance development? 6.Who requires a liver transplant and what is the outcome?

11. Hepatitis subgroup UK CHIC Membership Caroline SabinSanjay Bhagani Loveleen BansiAndrew Burroughs Teresa HillJanice Main Mark Nelson Martin FisherAlison Rodger Richard Gilson Chris Taylor