Impact of Hepatitis C Virus Coinfection on Response to Highly Active Antiretroviral Therapy and Outcome in HIV-Infected Individuals: A Nationwide Cohort Study

• Published in: Clinical infectious diseases 2006-05, Vol.42 (10), p.1481-1487
• Main Authors: Weis, Nina, Lindhardt, Bjarne Ø., Kronborg, Gitte, Hansen, Ann-Brit E., Laursen, Alex L., Christensen, Peer B., Nielsen, Henrik, Møller, Axel, Sørensen, Henrik T., Obel, Niels
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; AIDS; AIDS-Related Opportunistic Infections - mortality; AIDS-Related Opportunistic Infections - virology; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiretroviral drugs; Antiretroviral Therapy, Highly Active; Antiviral agents; Biological and medical sciences; CD4 Lymphocyte Count; Cells; Clinical outcomes; Cohort Studies; Coinfection; Death; Denmark - epidemiology; Drug therapy; Female; Hepacivirus; Hepatitis; Hepatitis C - complications; Hepatitis C - mortality; Hepatitis C virus; Highly active antiretroviral therapy; HIV; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - mortality; HIV Infections - virology; HIV/AIDS; Human immunodeficiency virus; Human immunodeficiency virus 1; Human viral diseases; Humans; Infections; Infectious diseases; Injections; Male; Medical sciences; Middle Aged; Mortality; Multivariate analysis; Patients; Pharmacology. Drug treatments; Prevalence; Risk factors; Studies; Survival Analysis; Treatment Outcome; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral hepatitis; Viral Load
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/503569

Background. Coinfection with hepatitis C virus (HCV) in human immunodeficiency virus (HIV) type 1—infected patients may decrease the effectiveness of highly active antiretroviral therapy. We determined the impact of HCV infection on response to highly active antiretroviral therapy and outcome among Danish patients with HIV-1 infection. Methods. This prospective cohort study included all adult Danish HIV-1—infected patients who started highly active antiretroviral therapy from 1 January 1995 to 1 January 2004. Patients were classified as HCV positive (positive HCV serological test and/or HCV PCR results [443 patients {16%}]), HCV negative (consistent negative HCV serological test results [2183 patients {80%}]) and HCV-U (never tested for HCV [108 patients {4%}]). The study end points were viral load, CD4+ cell count, and mortality. Results. Compared with the HCV-negative group, overall mortality was significantly higher in the HCV-positive group (mortality rate ratio, 2.4; 95% confidence interval [CI], 1.9–3.0), as was liver disease—related mortality (mortality rate ratio, 16; 95% CI, 7.2–33). Furthermore, patients in the HCV-positive group had a higher risk of dying with a prothrombin time