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Racial difference in mortality among U.S. veterans with HCV/HIV coinfection

Nathan A Merriman1, Steven B Porter, Colleen M Brensinger

  • 1Division of Gastroenterology, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.

The American Journal of Gastroenterology
|February 24, 2006
PubMed

Insights

Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) coinfection leads to worse liver disease and higher mortality. A significant racial disparity in survival was observed among coinfected patients, warranting further investigation.

Area of Science:

  • Hepatology and Infectious Diseases
  • Clinical Virology
  • Epidemiology

Background:

  • Hepatitis C virus (HCV) infection poses significant health challenges.
  • Coinfection with human immunodeficiency virus (HIV) can alter disease progression.
  • Understanding the impact of coinfections and demographic factors is crucial for patient management.

Purpose of the Study:

  • To investigate the clinical and virological outcomes of HCV infection in patients coinfected with HIV.
  • To assess the influence of race on the outcomes of HCV/HIV coinfection.
  • To compare outcomes between coinfected patients and those with monoinfections.

Main Methods:

  • Retrospective analysis of 265 HCV/HIV coinfected, 251 HCV monoinfected, and 227 HIV monoinfected patients.
  • Data collected from 2000-2002 at the Philadelphia VA Medical Center.
  • Evaluation of clinical and virological parameters, including liver function, mortality, CD4 counts, and viral titers.

Main Results:

  • HCV/HIV coinfection was linked to increased liver function abnormalities (37% vs 21%/20%) and higher mortality (17% vs 6%/9%) compared to monoinfections.
  • Coinfection did not significantly worsen HIV parameters (CD4, HIV titer) or increase HCV titers.
  • Mortality was significantly higher in white (31%) versus black (15%) HCV/HIV coinfected patients, a disparity not seen in monoinfected groups.

Conclusions:

  • HCV/HIV coinfection is associated with more severe liver disease and increased mortality.
  • Coinfection does not appear to directly impact CD4 counts or viral titers.
  • A notable racial disparity in mortality exists among HCV/HIV coinfected individuals, requiring further study.
Abstract

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