Revista de SIDA e investigación clínica

Co-infection with Hepatitis C Virus Increases Mortality in HIV-1 infected Patients through Increased Liver-Related Deaths Rather Than By Increasing Malignancy Related Deaths

Abstract

Daniel O Griffin, Michael J Metzger, Sheena Bharti, Arif Dharsee, Juan Carlos Rico and Joseph McGowan

Background: HIV-1-infected patients are living longer since the introduction of highly effective antiretroviral therapy (HAART). There is evidence that hepatitis C virus (HCV)/HIV-1 co-infection may result in an increased risk of death compared to patients infected only with HIV-1. Prior studies looking at this association have been limited by their enrollment of populations composed of mainly young MSM males. We investigated HCV/HIV-1-co-infection for an increased odds ratio for all cause mortality in a cohort representative of the current population in the US living with HIV-1-infection.

Methods: We performed an age-and-sex 1:1 matched case control study. We evaluated all deaths (n=153) that occurred in a cohort of ~2000 patients from January 1, 2010-December 31, 2014 (~10,000 patient life years) at a suburban clinic outside the NYC metropolitan area with a significant number of women and older individuals living with HIV-1-infection. We compared this cohort to an age and sex matched population selected from among 395 enrolled living HIV-1-infected controls.

Results: We observed that HCV/HIV-1-co-infection was associated with an increased odds ratio for all cause mortality of 1.83 (95% CI, 0.99, 3.43; P=0.038) compared to HIV-1-mono-infected patients. Liver related deaths were the main cause of death with an odds ratio for liver related death with of 6.59 (95% CI, 1.70, 25.70; P=0.0005).

Conclusion: In an HIV-1-infected cohort, HCV/HIV-1-co-infection is associated with an increased odds ratio for all cause mortality driven by liver related mortality.