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Hepatitis C virus co-infection is a negative prognostic factor for clinical evolution in human immunodeficiency
Insights
Hepatitis C virus (HCV) significantly accelerates clinical progression in patients with human immunodeficiency virus (HIV). Active HCV management is crucial for co-infected individuals to improve health outcomes.
Area of Science:
- Infectious Diseases
- Immunology
- Hepatology
Background:
- Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) are frequently co-infecting viruses.
- Understanding the impact of HCV on HIV disease progression is critical for patient management.
Purpose of the Study:
- To evaluate the influence of hepatitis C virus (HCV) co-infection on the clinical and immunological progression of human immunodeficiency virus (HIV)-infected patients.
Main Methods:
- A longitudinal study involving 812 HIV-infected patients across 13 centers.
- Comparison of clinical and immunological progression between HIV-monoinfected and HCV-HIV co-infected groups.
- Clinical progression defined by Karnofsky's index, body weight loss, AIDS-defining illness, or death.
Main Results:
- Immunological progression (CD4 count < 200 mm⁻³) did not differ significantly between groups (P=0.25).
- Clinical progression was significantly faster in HCV-HIV co-infected patients (univariate P=0.02; multivariable HR=1.63, P=0.03).
Conclusions:
- Hepatitis C virus (HCV) co-infection accelerates clinical disease progression in human immunodeficiency virus (HIV)-infected individuals.
- Active management of chronic hepatitis C infection is recommended for HCV-HIV co-infected patients.
Abstract:
A longitudinal study of human immunodeficiency virus (HIV)-infected individuals followed-up in 13 centres was performed to assess the influence of hepatitis C virus (HCV) on the clinical and immunological evolution of HIV-infected patients. Eight-hundred and twelve HIV-infected patients with known HIV acquisition date, 89 co-infected with HCV, were included in the cohort. Clinical progression was defined as: 30% decrease of Karnofsky's index; and/or 20% body weight loss; and/or acquired immune deficiency syndrome (AIDS)-defining illness; and/or death (except by accident, suicide, or overdose). Immunological progression was defined as a decrease of initial CD4 count to below 200 mm(-3). If immunological progression was not statistically different between groups (P=0.25), clinical progression was significantly faster in HCV-HIV co-infected patients in univariate (P=0.02) and multivariable survival analysis (hazard ratio=1.63, P=0.03). This argues for active management of hepatitis C chronic infection among HCV-HIV co-infected patients.