Impact of chronic hepatitis C infection on outcomes of patients with an advanced stage of HIV-1 infection in an area of low prevalence of co-infection
Journal
International Journal of STD and AIDS
Journal Volume
16
Journal Issue
1
Pages
42-48
Date Issued
2005
Author(s)
Abstract
To ascertain whether hepatitis C (HCV) co-infection affects the progression of HIV infection, we initiated an eight-year prospective observational study at a university hospital in Taiwan where seroprevalences of HCV antibody and HIV antibody were low. Fifty-three (12.0%) consecutive non-haemophiliac HIV-1-infected patients with HCV co-infection and 387 (88.0%) patients without HCV and hepatitis B co-infection were enrolled between June 1994 and June 2002 and observed until December 2002. Outcomes evaluated included the risk for acute hepatitis, hepatic decompensation, HIV disease progression and mortality, and changes of CD4 + count and plasma viral load (PVL) after initiation of highly active antiretroviral therapy (HAART) at the end of the study. The baseline CD4 + count, PVL and proportion of patients with AIDS-defining opportunistic illnesses (OI) at study entry were similar between patients with HCV co-infection and those without co-infection, but HCV-co-infected patients were older (39 versus 35 years, P = 0.01) and had a higher proportion of intravenous drug use (17.0% versus 0.8%, P < 0.001). After a total observation duration of 1137 patient-years (PY) (median, 791 days; range, 3-3053 days), the incidence of acute hepatitis in HCV-co-infected patients was 13.89 per 100 PY (95% confidence interval [CI], 13.31-14.49) and that in patients without co-infection was 6.39 per 100 PY (95% CI, 6.24-6.55 per 100 PY), with an adjusted odds ratio (OR) of 2.769 (95% CI, 1.652-4.640). At the end of the study, CD4+ count increased by 137 × 106 and 157 × 106/L in patients with and without HCV co-infection, respectively, (P = 0.47). The proportions of achieving undetectable PVL (<400 copies/mL) after HAART was similar (76.7% versus 74.9%, P = 0.79). The adjusted OR for development of new AIDS-defining OI was 1.826 (95% CI, 0.738-4.522) in HCV-co-infected patients as compared with HCV-uninfected patients. The adjusted hazards ratio for death of HCV-co-infected patients when compared with those without co-infection was 0.781 (95% CI, 0.426-1.432). Our findings suggested that HCV co-infection was associated with a significantly higher risk for acute hepatitis in HIV-infected patients receiving antiretroviral therapy, but it had no adverse impact on virological, immunological and clinical responses to HAART and survival when compared with patients without HCV and HBV co-infection.
SDGs
Other Subjects
antiretrovirus agent; CD4 antigen; hepatitis C antibody; Human immunodeficiency virus antibody; acute hepatitis; adult; aged; article; comorbidity; confidence interval; disease course; disease severity; female; hepatitis C; highly active antiretroviral therapy; human; Human immunodeficiency virus infection; intravenous drug abuse; liver failure; lymphocyte count; major clinical study; male; mortality; opportunistic infection; outcomes research; prevalence; priority journal; prospective study; seroprevalence; survival; Taiwan; virus load; Adult; Aged; AIDS-Related Opportunistic Infections; Antiretroviral Therapy, Highly Active; Disease Progression; Female; Hepatitis C, Chronic; HIV Infections; Hospitals, University; Humans; Incidence; Male; Middle Aged; Mycoses; Penicillium; Prevalence; Prospective Studies; Taiwan
Type
journal article