Risk for liver-related death far greater in HCV seropositive patients with HIV

Provided by Healio

Rockstroh JK. J Hepatol. 2013;doi:10.1016/j.jhep.2013.04.005.

May 15, 2013

Patients who were hepatitis C virus seropositive and coinfected with HIV had nearly a ninefold increased risk for liver-related death compared with patients who were HCV seronegative with no correlations to HCV viremia level or genotype in a recent study.

In a prospective study, researchers enrolled 13,025 patients (mean age, 37.5 years; 74.2% men) with HIV and known HCV antibody (HCVAb) from the EuroSIDA cohort (1994-2011) that included 18,295 HIV-1 infected patients from 105 centers in Europe, Israel and Argentina. Thirty-one percent of the patients had detectable HCVAb (n=4,044), including 3,745 who were seropositive at baseline and the remainder who initially were HCVAb negative but showed detectable anti-HCV antibodies during follow-up.

After adjustment, HCVAb positive patients had a statistically significant incidence rate ratio (IRR) of 8.9 (95% CI, 5.6-14.14) for liver-rated death (LRD) compared with HCVAb negative patients. Multivariables included sex, race, previous AIDs, region of Europe, age, HCV treatment status at baseline and exposure group.

Among 1,907 patients with evaluable HCV RNA, 52.9% were infected with HCV genotype 1; 3.3%, 29.7% and 14.2% had genotypes 2, 3 and 4, respectively. Patients with detectable HCV RNA had a greater but not significantly increased incidence of non-LRD (adjusted IRR=1.18; 95% CI, 0.93-1.5) compared with HCVAb positive patients without viremia, while their incidence of LRD was significantly increased (adjusted IRR=2.11; 95% CI, 1.30-3.42).

Researchers said HCV genotype and HCV RNA levels did not affect the risk for LRD or non-LRD among patients with HCV viremia.

“Our results demonstrate that patients with chronic HCV infection had an increased risk of liver-related death compared to patients with undetectable HCV RNA,” the researchers concluded. “However, levels of HCV viremia as well as the presence of HCV genotype 1 do not independently impact clinical outcome and survival in HIV/HCV coinfected patients.

“The ninefold increase of liver-related deaths in HCVAb positive compared to HCVAb negative patients once again underlines the urgent need to develop improved HCV treatment options in this particular patient group.”

Source