Epidemiology

HCV coinfection increases mortality in HIV patients

Last Updated: 2004-11-19 11:15:07 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Despite highly active antiretroviral therapy (HAART), it appears that hepatitis C virus (HCV) coinfection significantly increases mortality in patients with HIV infection, researchers report in the November 15th issue of Clinical Infectious Diseases. These findings are in contrast with study results obtained in pre-HAART era.

"The impact of HCV coinfection on HIV survival is controversial due to conflicting data from several large cohort studies," co-author Dr. Jodie L. Guest of the Atlanta VA Medical Center told Reuters Health.

To investigate further, Dr. Guest and colleagues "used our large VA cohort to study the impact of coinfection on survival and found that in the era of HAART and with longer follow-up, coinfection did adversely impact the survival of our patients after controlling for important confounding variables."

The researchers found that in 970 HIV-infected patients seen between January 1997 and May 2001, the prevalence of HCV coinfection was 31.6%. Co-infection was significantly more likely in patients who were older, black or injection drug users.

The results of multivariate analysis indicated that survival from the time of AIDS diagnosis was significantly shorter for coinfected patients (hazard ratio 1.84), "as was time from HIV diagnosis to death (HR 2.47)," the researchers report.

Altogether, Dr. Guest concluded, "it is likely that the varying results seen in the literature are due to cohort and methodological differences."

Clin Infect Dis 2004;39:1507-1513.