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News

Racial difference in mortality in Hep C/HIV coinfected veterans

April's American Journal of Gastroenterology shows that Hep C/HIV coinfection is associated with worsened liver disease and higher mortality than Hep C alone, and finds racial disparity in survival of coinfected patients.

News image

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Dr Nathan Merriman and colleagues examined the impact of viral coinfections and race on clinical and virological outcome of Hepatitis C infection.

The investigative team included 3 groups of patients.

Group 1 included 265 Hepatitis C virus /human immunodeficient virus (HIV) coinfected patients.

Group 2 had 251 Hepatitis C virus monoinfected patients, and Group 3 included 227 HIV monoinfected patients.

The team assessed the patients between 2000 and 2002 from the computerized patient record system at the Philadelphia VA Medical Center.

The investigative team analyzed clinical and virological parameters.

The team found that Hepatitis C /HIV coinfection was associated with a higher frequency of liver function abnormalities.

The frequency of liver abnormalities in Group 1 was 37%, whereas it was 21% in Group 2 and 20% in Group 3.

Hepatitis C /HIV coinfection was also associated with greater mortality over a 3 year period.

The mortatiliy rates in Group 1 was 17%, compared with 6% and 9% in Groups 2 and 3, respectively.

The racial disparity in mortality was not explained by a history of alcohol use disorder
American Journal of Gastroenterology

However, the team observed that Hepatitis C /HIV coinfection was not associated with worsened HIV-related parameters.

Hepatitis C /HIV coinfection was also not associated with use of antiretroviral therapy or increased Hepatitis C virus titers compared to monoinfection.

Mortality among Hepatitis C /HIV coinfected patients was significantly greater in white than in black patients, at 31% vs 15%, respectively.

This racial disparity in mortality was not apparent in the monoinfected groups and not explained by Hepatitis B coinfection or history of alcohol use disorder.

Dr Merriman's team concluded, “Hepatitis C /HIV coinfection is associated with worsened liver disease and higher mortality than Hepatitis C or HIV monoinfection without directly influencing CD4 count and Hepatitis C virus or HIV titers.”

“Furthermore, we demonstrated a racial disparity in survival of Hepatitis C /HIV-coinfected patients that needs further investigation.”

Am J Gastroenterol 2006:101(4):760
21 April 2006

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