Sleep disturbances in HIV-HCV coinfected patients: indications for clinical management in the HCV cure era (ANRS CO13 HEPAVIH cohort).

Marie Costa (1, 2) , Teresa Rojas Rojas (1, 2) , Denis Lacoste (3) , Virginie Villes (1, 2) , Hugues Aumaitre (4) , Camelia Protopopescu (1, 2) , Issifou Yaya (1, 2) , Linda Wittkop (5, 6) , Jessica Krause (7) , Dominique Salmon-Ceron (8, 9) , Fabienne Marcellin (1, 2) , Philippe Sogni (8, 10, 11) , Maria P Carrieri (1, 2)

1 SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale
2 ORS PACA - Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille]
3 COREVIH Aquitaine - Coordination Régionale de la lutte contre l'infection à VIH
4 Service des maladies infectieuses [CH Perpignan]
5 INSERM U1219 - UB - ISPED - Team MORPH3EUS
6 Pôle de Santé Publique - Service d’information Médicale [CHU de Bordeaux]
7 CHU Saint-Antoine [AP-HP]
8 UPD5 - Université Paris Descartes - Paris 5
9 Service Maladies infectieuses et tropicales [AP-HP Hôpital Cochin]
10 Inserm U1223 - Physiopathologie du système immunitaire
11 Service d'hépatologie médicale [CHU Cochin]

OBJECTIVES: Although common among patients coinfected with HIV and hepatitis C virus (HCV), sleep disturbances (SD) are still poorly documented in this population in the HCV cure era. This longitudinal study aimed at analysing SD in HIV-HCV coinfected patients and identifying their clinical and sociobehavioural correlates. METHODS: We used 5-year annual follow-up data from 1047 participants in the French National Agency for Research on Aids and Viral Hepatitis Cohort 13 'Hépatite et VIH' (ANRS CO13 HEPAVIH) cohort of HIV-HCV coinfected patients to identify clinical (medical records) and behavioural (self-administered questionnaires) correlates of SD (mixed-effects logistic regression). SD were identified using one item documenting the occurrence of insomnia or difficulty falling asleep (ANRS 'Action Coordonnée 24' self-reported symptoms checklist), and two items documenting perceived sleep quality (Center for Epidemiologic Studies Depression and WHO Quality of Life HIV-specific brief scales). RESULTS: Seven hundred and sixteen (68.4%) patients with completed self-administered questionnaires reported SD at their most recent follow-up visit. In the multivariable model, hazardous alcohol consumption (Alcohol Use Disorders Identification Test-Consumption score≥4 for men, ≥3 for women) (adjusted odds ratio=1.61; 95% confidence interval: 1.09-2.36), depressive symptoms (6.78; 4.36-10.55) and the number of other physical and psychological self-reported symptoms (1.10; 1.07-1.13) were associated independently with SD after adjustment for sex, age and employment status. HCV cure was not associated significantly with SD. CONCLUSION: SD remain frequent in HIV-HCV coinfected patients and are associated with a series of modifiable behavioural risk factors. Independent of HCV cure, improved screening and comprehensive management of alcohol use, physical and psychological self-reported symptoms and depression are essential in this population. Closer investigation of these risk factors of SDs may both increase sleep quality and indirectly improve patients' clinical outcomes.

Domaines: Hépatologie et Gastroentérologie; Santé publique et épidémiologie; Maladies infectieuses

Marie Costa, Teresa Rojas Rojas, Denis Lacoste, Virginie Villes, Hugues Aumaitre, et al.. Sleep disturbances in HIV-HCV coinfected patients: indications for clinical management in the HCV cure era (ANRS CO13 HEPAVIH cohort).. European Journal of Gastroenterology & Hepatology, 2019, Epub ahead of print. ⟨10.1097/MEG.0000000000001441⟩. ⟨inserm-02272278⟩