Hepatitis C in HIV-infected patients with and without AIDS: prevalence and relationship to patient survival

T L Wright1, H Hollander, X Pu

  • 1Department of Medicine, University of California, San Francisco 94121.

Insights

Hepatitis C virus (HCV) infection is more common in HIV-positive men who have sex with men, suggesting sexual transmission. HCV coinfection does not impact survival in these patients.

Area of Science:

  • Virology
  • Infectious Diseases
  • Epidemiology

Background:

  • Limited data exists on Hepatitis C virus (HCV) prevalence in Human Immunodeficiency Virus (HIV) patients and its effect on survival.
  • Investigating risk factors beyond traditional routes like intravenous drug use is crucial.

Purpose of the Study:

  • To determine the prevalence of HCV infection in HIV-positive individuals, particularly non-intravenous drug users.
  • To explore potential transmission routes, such as homosexual contact.
  • To assess the impact of HCV coinfection on the survival of HIV-infected patients.

Main Methods:

  • Retrospective study of 512 predominantly non-intravenous drug-using, homosexual men, including 224 with AIDS.
  • HCV antibody testing using enzyme immunoassay, confirmed by strip immunoblot assay and HCV RNA detection via polymerase chain reaction.
  • Testing of enzyme immunoassay-negative samples for HCV RNA to identify occult infections.

Main Results:

  • HCV infection prevalence was 11.7% in individuals without a history of intravenous drug use or transfusion.
  • 87% of enzyme immunoassay-positive samples confirmed positive by further testing.
  • HCV RNA was detected in 53% of antibody-positive samples, but rarely in antibody-negative samples (approx. 1%).
  • HCV coinfection did not significantly affect survival in HIV-infected patients, regardless of AIDS status.

Conclusions:

  • HCV infection is significantly more prevalent in HIV-positive, non-intravenous drug-using men than in blood donors, suggesting homosexual transmission.
  • Serologically occult HCV viremia is uncommon; approximately half of seropositive individuals have detectable HCV RNA.
  • HCV coinfection does not appear to negatively influence survival outcomes in HIV-infected individuals.
Abstract

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