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Survival of HIV-infected patients with compensated liver cirrhosis

Paula Tuma1, Inmaculada Jarrin, Julia Del Amo

  • 1Department of Infectious Diseases, Hospital Carlos III, Spain.

AIDS (London, England)
|February 16, 2010
PubMed

Insights

Mortality in HIV patients with liver cirrhosis is high, with older age, low CD4 counts, and detectable HIV RNA being key predictors. Hepatic elastometry and MELD scores accurately predict mortality in this population.

Area of Science:

  • Hepatology and Infectious Diseases
  • HIV/AIDS Research
  • Clinical Outcomes and Prognosis

Background:

  • Liver-related mortality is a leading cause of non-AIDS deaths in HIV-infected patients on HAART.
  • Chronic hepatitis B and C are primary drivers of end-stage liver disease in this population.

Purpose of the Study:

  • To examine mortality incidence and predictors in HIV-infected patients with compensated liver cirrhosis.
  • To evaluate the predictive accuracy of elastometry, Child-Pugh, and MELD scores for mortality.

Main Methods:

  • Prospective follow-up of 194 HIV-positive cirrhotic patients from October 2004 to December 2008.
  • Analysis of mortality rates and associated factors using multivariate analyses.
  • Assessment of elastometry, Child-Pugh, and MELD scores for mortality prediction.

Main Results:

  • Overall mortality rate was 5.8 deaths per 100 patient-years.
  • Independent predictors of mortality included age ≥50, CD4 <200 cells/µL, and detectable plasma HIV-RNA.
  • MELD score ≥11 and hepatic elastometry >28.75 kPa were significant predictors of mortality.

Conclusions:

  • HIV patients with compensated cirrhosis have a high annual mortality rate (5.8%) in the HAART era.
  • Older age, low CD4 counts, and detectable HIV RNA are associated with increased mortality.
  • Hepatic elastometry and MELD scores demonstrate strong predictive accuracy for mortality in this cohort.
Abstract

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