Liver-related mortality and hospitalizations attributable to chronic hepatitis C virus coinfection in persons living with HIV

A Mena; H Meijide; I Rodríguez-Osorio; A Castro; E Poveda

doi:10.1111/hiv.12502

Liver-related mortality and hospitalizations attributable to chronic hepatitis C virus coinfection in persons living with HIV

HIV Med. 2017 Oct;18(9):685-689. doi: 10.1111/hiv.12502. Epub 2017 Feb 23.

Authors

A Mena¹, H Meijide^{1

2}, I Rodríguez-Osorio¹, A Castro¹, E Poveda¹

Affiliations

¹ Clinical Virology group, Institute of Biomedical Research of A Coruña (INIBIC)-University Hospital of A Coruña (CHUAC), Sergas, University of A Coruña (UDC), A Coruña, Spain.
² Internal Medicine Service, Quiron Hospital, A Coruña, Spain.

PMID: 28230318
DOI: 10.1111/hiv.12502

Abstract

Objectives: The aim of this study was to compare liver-related mortality and liver-related hospitalizations for persons living with HIV (PLWH) with and without hepatitis C virus (HCV) exposure, and to estimate the fraction of liver disease attributable to chronic HCV coinfection.

Methods: An ambispective cohort study followed PLWH between 1993 and 2014. PLWH were classified into three groups: those who were HIV-monoinfected, those who cleared HCV spontaneously and those with chronic HCV coinfection. Liver-related mortality was estimated for the three groups and compared with the adjusted standardized mortality ratio.

Results: Data for 2379 PLWH were included in the study (1390 monoinfected individuals, 146 spontaneous HCV resolvers and 843 with chronic HCV coinfection). Global mortality was 33.8%, 21.4% of which was liver-related. Patients who died from liver-related causes were mostly on antiretroviral therapy and had an undetectable HIV viral load when they died. The liver-related mortality rate in those with chronic HCV coinfection was 10.01 per 1000 patient-years vs. 3.84 per 1000 patient-years in the HIV-monoinfected group (P < 0.001). The adjusted standardized mortality ratio in the chronically HCV-coinfected group was 4.52 (95% confidence interval 2.98-5.86). The fractions of liver-related mortality and liver-related hospitalizations attributable to chronic HCV coinfection were 0.61 and 0.74, respectively. There were no differences in liver-related events between HIV-monoinfected individuals and those who spontaneously cleared HCV.

Conclusions: Chronic HCV infection increases the risk of liver-related mortality and liver-related hospitalizations in PLWH, despite good control of HIV infection. Sixty per cent of liver-related mortality in chronically HCV-coinfected PLWH could be attributable to chronic HCV infection. The effect of mass HCV eradication with new therapies should be evaluated.

Keywords: hepatitis C virus coinfection; liver-related hospitalization; liver-related mortality; people living with HIV.

Publication types

Comparative Study
Research Support, Non-U.S. Gov't

MeSH terms

Cohort Studies
Coinfection / mortality
Female
HIV Infections / mortality
HIV Infections / virology*
Hepatitis C, Chronic / epidemiology
Hepatitis C, Chronic / mortality*
Hospitalization
Humans
Liver Diseases / mortality
Liver Diseases / virology*
Male
Risk Factors