SCHMIDBAUER Caroline

Changes in the Epidemiology of Liver Disease in HIV+ Patients - a Retrospective Exploratory Data Analysis

Background: In the era of effective antiretroviral therapy (ART) the epidemiology of HIV (human immunodeficiency virus) infection has been rapidly changing towards an overall decrease in incidence and an increase in global prevalence, mirroring the effects of ART both in terms of transmission prevention and beneficial long-term effects on HIV course. Yet, despite these promising developments, HIV remains a main contributor to morbidity and mortality worldwide. In addition, HIV is known to have a negative impact on the course of other medical conditions, such as liver diseases which have become the secondleading cause of death in HIV infected patients. While some liver diseases are preventable by vaccination, like hepatitis B and D Virus (HBV/HDV) infection, there are effective treatment options for others, like hepatitis C Virus (HCV) infection with the introduction of direct acting antiviralagents. The changing demographics and patient characteristics call for novel prevention and screening strategies for non-alcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH) in HIV patients. With the introduction and wide use of new treatment Regimen sfor HIV as well as HCV infection special attention needs to be paid to drug-drug interactions and drug-induced liver injury (DILI).

Aims: In this doctoral thesis I will characterize a cohort of HIV-infected patients with regard to different etiologies of liver disease (HBV, HCV, ART-related DILI, NAFLD/NASH) and their dynamics in epidemiology as well as mortality rates by performing a retrospective exploratory data analysis. Patients having presented to the Vienna General Hospital between 01.01.2014 and 31.12.2016 will be included in the study. Using the data documented in the HIP (HIV Patient Management System) I will assess HBV immunization and infection Status according to serology, prevalence of HCV infection according to serology and PCR, ART related DILI in the context of newly implemented ART-regimens, prevalence of NAFLD/NASH, and finally analyze mortality rates in liver disease-specific subgroups. 

Methods and Skills:

Clinical Studies; retrospective data analysis; medical statistics

Publications:

Zoufaly A, Kraft C, Schmidbauer C, Puchhammer-Stöckl E. Prevalence of integrase inhibitor resistance mutations in Austrian patients recently diagnosed with HIV from 2008 to 2013. Infection 45: 165-170, 2017