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Effect of HCV infection on cause-specific mortality after HIV seroconversion

The latest issue of Gastroenterology investigates the effect of HCV infection on cause-specific mortality after HIV seroconversion.

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Individuals with human immunodeficiency virus infection frequently also are infected with hepatitis C virus, but little is known about its effects on the progression of HIV-associated disease.

Dr Jannie van der Helm determined the effects of co-infection on mortality from HIV and/or acquired immune deficiency syndrome, and hepatitis or liver disease, adjusting for the duration of HIV infection.

The team analyzed data from the 16 cohorts of the Concerted Action on Seroconversion to AIDS and Death in Europe collaboration, which included information on HCV infection and cause of death.

A competing-risks proportional subdistribution hazards model was used to evaluate the effect of hepatitis C virus infection on the following causes of death, including HIV- and/or AIDS-related, hepatitis- or liver-related, natural, and non-natural.

The doctors noted that of 9164 individuals with HIV infection and a known date of seroconversion, 2015 also were infected with hepatitis C virus.

Co-infected individuals had a higher risk of death from hepatitis or liver disease
Gastroenterology

Of 718 deaths, 395 were caused by HIV infection and/or AIDS, and 39 were caused by hepatitis or liver-related disease.

The team of researchers found that among individuals infected with only HIV or with co-infection, the mortality from HIV infection and/or AIDS-related causes and hepatitis or liver disease decreased significantly after 1997, when combination antiretroviral therapy became widely available.

However, after 1997, HIV and/or AIDS-related mortality was higher among co-infected individuals than those with only HIV infection in each risk group, including injection drug use, sex between men and women or hemophilia, and sex between men.

Compared with individuals infected with only HIV, co-infected individuals had a higher risk of death from hepatitis or liver disease.

Dr van der Helm's team commented, "Based on analysis of data from the Concerted Action on Seroconversion to AIDS and Death in Europe collaboration, since 1997, when combination antiretroviral therapy became widely available, individuals co-infected with HIV, and hepatitis C virus have had a higher risk of death from HIV and/or AIDS, and from hepatitis or liver disease, than patients infected with only HIV."

"It is necessary to evaluate the effects of hepatitis C virus therapy on HIV progression."

Gastroenterol 2013: 144(4): 751-760
03 April 2013

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