Epidemiology

Outcomes worse for HCV/HIV coinfection than just HIV or HCV, especially in whites

Last Updated: 2006-04-18 11:22:28 -0400 (Reuters Health)

By Will Boggs, MD

NEW YORK (Reuters Health) - Liver disease and mortality are worse with hepatitis C virus (HCV)/HIV coinfection than with either infection by itself, especially among white veterans, according to a report in the April American Journal of Gastroenterology.

"We need to better understand why the coinfected patients do so poorly and the underlying mechanism for apparent racial disparity in their outcome," co-author Dr. Kyong-Mi Chang, from the University of Pennsylvania and Philadelphia Veterans Affairs Medical Center, told Reuters Health. "We also need better drugs that directly target HCV."

Dr. Chang and colleagues examined the impact of viral coinfection and race on clinical and biological outcomes in 265 HCV/HIV-coinfected, 251 HCV-monoinfected, and 227 HIV-monoinfected veterans.

HCV/HIV coinfected patients had significantly greater abnormalities in albumin level, international normalized ratio (INR), and platelet count than did HCV-monoinfected patients or HIV-monoinfected patients, the authors report.

HIV-associated outcomes did not differ significantly between HCV/HIV-coinfected patients and HIV-monoinfected patients, the results indicate.

Mortality was significantly greater among HCV/HIV-coinfected patients than among patients monoinfected with either HCV or HIV, the researchers note. After adjustment for a variety of factors, HCV-monoinfected patients were only 29% as likely to die and HIV-monoinfected patients were only 31% as likely to die as HCV/HIV-coinfected patients.

During the three-year study period, twice as many white patients died compared to black patients, the report indicates, and the median age of death in white patients (46 years) was significantly younger than the median age of death in black patients (52 years).

Am J Gastroenterol 2006;101:760-767.