Clinical

Hepatitis C coinfection hampers benefits of HAART in HIV patients

Last Updated: 2003-07-30 15:01:16 -0400 (Reuters Health)

By David Douglas

NEW YORK (Reuters Health) - Despite undergoing highly active antiretroviral therapy (HAART), patients infected with both hepatitis C virus (HCV) and HIV are at increased risk of hospitalization and death, Canadian researchers report in the July 1st issue of the Journal of Acquired Immune Deficiency Syndromes

As lead investigator Dr. Marina B. Klein told Reuters Health, "Hepatitis C coinfection, along with other associated factors such as injection drug use, have prevented such individuals from realizing the substantial health gains brought about by HAART."

Dr. Klein and colleagues at McGill University Health Centre, Montreal, initially hypothesized that "it is quite likely that HCV-coinfected patients may not have derived equal benefit from the revolution brought about by HAART."

To investigate, the researchers conducted a retrospective cohort study covering the eras before and after the introduction of HAART. In total, 125 HCV-positive patients, 83% of whom were injection drug users, were involved, as were 1076 HCV-negative patients.

Altogether, say the investigators, the HCV-coinfected patients "experienced no clear benefit from HAART." Compared to the pre-HAART era, post-HAART adjusted hazard ratios for opportunistic infections were 0.74, for hospitalization 2.1, and for death 1.78.

In contrast, corresponding figures for HCV negative patients were 0.49, 0.51 and 0.28.

The researchers also note that deaths and hospitalizations in HCV-positive patients "were primarily for non-AIDS-defining infections and complications of injection drug use."

Summing up, Dr. Klein said, "The main conclusion that we drew from our research is that unless hepatitis C infection and associated behaviors are directly dealt with, coinfected patients will continue to suffer significant rates of illness and death that might be otherwise preventable."

J Acquir Immune Defic Syndr 2003;33:365-372.