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Effect of HCV infection on cause-specific mortality after HIV seroconversion, before and after 1997

Jannie van der Helm1, Ronald Geskus, Caroline Sabin

  • 1Public Health Service Amsterdam, Amsterdam, the Netherlands. jvdhelm@ggd.amsterdam.nl

Gastroenterology
|December 26, 2012
PubMed

Insights

Individuals with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) co-infection face higher mortality risks from HIV/AIDS and liver disease. This increased risk persists even after combination antiretroviral therapy became widely available.

Area of Science:

  • Infectious Diseases
  • Hepatology
  • Epidemiology

Background:

  • Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) co-infection is common.
  • The impact of HCV co-infection on HIV disease progression and mortality remains incompletely understood.

Purpose of the Study:

  • To determine the effect of HCV co-infection on mortality from HIV/AIDS and hepatitis/liver disease.
  • To adjust for the duration of HIV infection in the analysis.

Main Methods:

  • Analysis of data from the Concerted Action on Seroconversion to AIDS and Death in Europe (CASCADE) collaboration.
  • Utilized a competing-risks proportional subdistribution hazards model.
  • Evaluated mortality from HIV/AIDS-related, hepatitis/liver-related, natural, and non-natural causes.

Main Results:

  • After 1997, mortality from HIV/AIDS and liver disease decreased for both HIV-only and co-infected individuals.
  • However, HIV/AIDS-related mortality remained higher in co-infected individuals across various risk groups.
  • Co-infected individuals exhibited a higher risk of death from hepatitis or liver disease compared to HIV-only individuals.

Conclusions:

  • Since 1997, HIV/HCV co-infected individuals have a greater risk of death from HIV/AIDS and liver disease than those with HIV alone.
  • The findings underscore the need to evaluate the impact of HCV therapy on HIV progression.
Abstract

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