Research Papers

@article{Cox2017,

title = {Food Insecurity in HIV-Hepatitis C Virus Co-infected Individuals in Canada: The Importance of Co-morbidities},

author = {Joseph Cox and Anne-Marie Hamelin and Taylor McLinden and Erica E. M. Moodie and Aranka Anema and Kathleen C. Rollet-Kurhajec and Gilles Paradis and Sean B. Rourke and Sharon Walmsley and Marina B. Klein},

url = {https://www.ncbi.nlm.nih.gov/pubmed/26912217},

doi = {10.1007/s10461-016-1326-9},

year  = {2017},

date = {2017-03-15},

journal = {AIDS and Behavior},

abstract = {While research has begun addressing food insecurity (FI) in HIV-positive populations, knowledge regarding FI among individuals living with HIV-hepatitis C virus (HCV) co-infection is limited. This exploratory study examines sociodemographic, socioeconomic, behavioral, and clinical factors associated with FI in a cohort of HIV-HCV co-infected individuals in Canada. We analyzed longitudinal data from the Food Security and HIV-HCV Co-infection Study of the Canadian Co-infection Cohort collected between November 2012-June 2014 at 15 health centres. FI was measured using the Household Food Security Survey Module and classified using Health Canada criteria. Generalized estimating equations were used to assess factors associated with FI. Among 525 participants, 59 % experienced FI at their first study visit (baseline). Protective factors associated with FI (p < 0.05) included: enrolment at a Quebec study site (aOR: 0.42, 95 % CI: 0.27, 0.67), employment (aOR: 0.55, 95 % CI: 0.35, 0.87), and average personal monthly income (aOR per $100 CAD increase: 0.98, 95 % CI: 0.97, 0.99). Risk factors for FI included: recent injection drug use (aOR: 1.98, 95 % CI: 1.33, 2.96), trading away food (aOR: 5.23, 95 % CI: 2.53, 10.81), and recent experiences of depressive symptoms (aOR: 2.11, 95 % CI: 1.48, 3.01). FI is common in this co-infected population. Engagement of co-infected individuals in substance use treatments, harm reduction programs, and mental health services may mitigate FI in this vulnerable subset of the HIV-positive population.},

keywords = {Canada, Co-infection, Food insecurity, HCV, HIV},

pubstate = {published},

tppubtype = {article}

}

@article{Rossi2016,

title = {Frequent injection cocaine use increases the risk of renal impairment among Hepatitis C and HIV co-infected patients},

author = {Carmine Rossi and Joseph Cox and Curtis Cooper and Valérie Martel-Laferrière and Sharon Walmsley and John Gill and Ruth Sapir-Pichhadze and Erica E. M. Moodie and Marina B. Klein},

url = {https://www.ncbi.nlm.nih.gov/pubmed/26859371},

doi = {10.1097/QAD.0000000000001060},

year  = {2016},

date = {2016-06-01},

journal = {AIDS},

abstract = {OBJECTIVE:

To examine the association between injection cocaine use, hepatitis C virus (HCV) infection, and chronic renal impairment (CRI).

DESIGN:

Prospective observational cohort study of HIV-HCV coinfected patients.

METHODS:

Data from 1129 participants in the Canadian Co-Infection Cohort with baseline and follow-up serum creatinine measurements between 2003 and 2014 were analyzed. Prevalent and incident cohorts were created to examine the association between self-reported past, current, and cumulative cocaine use and chronic HCV with CRI. CRI was defined as an estimated glomerular filtration rate below 70 ml/min per 1.73 m. Multivariate logistic regression was used to calculate odds ratios, and discrete-time proportional-hazards models were used to calculate hazard ratios for cocaine use, in the two respective cohorts, adjusted for HCV RNA and important demographic, HIV disease stage, and comorbidity confounders.

RESULTS:

Eighty-seven participants (8%) had prevalent CRI. Past injection cocaine use was associated with a two-fold greater risk of prevalent CRI [odds ratio 2.03, 95% confidence interval (CI) 0.96, 4.32]. During follow-up, 126 of 1061 participants (12%) developed incident CRI (31 per 1000 person-years). Compared to nonusers, heavy (≥ 3 days/week) and frequent injection cocaine users (≥75% of follow-up time) experienced more rapid progression to CRI (hazard ratio 2.65, 95% CI 1.35, 5.21; and hazard ratio 1.82, 95% CI 1.07, 3.07, respectively). There was no association between chronic HCV and CRI in either cohort.

CONCLUSION:

After accounting for HCV RNA, frequent and cumulative injection cocaine abuse was associated with CRI progression and should be taken into consideration when evaluating impaired renal function in HIV-HCV coinfection.},

keywords = {Chronic hepatitis C, Co-infection, Cocaine, HIV, Intravenous substance abuse, Renal insufficiency},

pubstate = {published},

tppubtype = {article}

}