Objectives

The main objective of this study is to determine the effect of antiretroviral therapy (ART) on liver disease progression in people who are co-infected with HIV and hepatitis C (HCV).

Our research is focused on identifying several factors linked to liver disease progression in HIV-HCV co-infection by:

  • Evaluating the effect of ART and ART interruptions on progression of end-stage liver disease (ESLD);
  • Estimate effect of ART on fibrosis progression using surrogate markers and progression to clinical ESLD events and death
  • Examining the effects of drug and alcohol use on liver disease progression, and behavioural risk factors;
  • Determining the rates of chronic toxicities, specifically hepatic steatosis and insulin resistance, according to ART use;
  • Evaluate the role of HCV treatment in modifying liver disease progression rates;
  • Evaluate the role of non-invasive markers of hepatic fibrosis in predicting disease progression;
  • Use the infrastructure and data from the cohort to investigate new cutting edge questions;
  • Establishing a tissue bank of peripheral blood mononuclear cells (PBMC), plasma, serum and liver tissue for additional research about immune function, viral dynamics, and mechanisms of fibrosis.

We are also developing and validating non-invasive methods for measuring liver disease progression in order to easily monitor it and intervene prior to the onset of end-stage liver disease.

Our long-term goal is to study how to slow liver disease progression in co-infected patients. We will examine the role of HCV treatment in the progression of liver disease with a focus on evaluating access to treatment, predictors of response, and characteristics of those who respond to treatment compared to those who do not.