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and Hepatitis.com Coverage of the
50th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2010)
Worse Fibrosis Predicts Death in HIV/HCV Coinfected Individuals, Interferon Therapy Lowers Risk
HIV positive people with chronic hepatitis C virus (HCV) infection tend to experience more rapid liver disease progression than those with HCV alone, but the influence of coinfection on mortality has not been extensively studied.
R. SanMartin and colleagues from University Hospital Germans Trias i Pujol in Badalona conducted a study to evaluate factors predicting death in a cohort of HIV/HCV coinfected patients who received liver biopsies between 1997 and 2006 and were followed prospectively.
The analysis included 363 coinfected participants recruited from a tertiary teaching hospital. About three-quarters were men, the mean age was 38 years, and most had a history of injection drug use. Just over half had hard-to-treat HCV genotype 1 and about 30% had advanced liver fibrosis (stages F3-F4).
At study entry participants were required to have stable HIV infection without co-morbid conditions or active illicit drug or heavy alcohol use. More than 90% were on combination antiretroviral therapy (ART) and 70% had HIV viral load < 200 copies/mL. The current median CD4 cell count was high, at 556 cells/mm3, but the CD4 nadir (lowest-ever level) was 207 cells/mm3, and about 20% had been diagnosed with AIDS.
Participants were monitored every 6 months for an average follow-up duration of 4.5 years.
Based on these results, the investigators concluded, "Among all HIV and HCV related characteristics, liver fibrosis stage is the only independent factor associated with death [due to] any cause. Patients who received interferon had also lower mortality rates."
Investigator affiliation: Hosp. Univ. Germans Trias i Pujol, Badalona, Spain.