Hepatitis C in HIV‐infected patients with and without AIDS: Prevalence and relationship to patient survival

• Published in: Hepatology (Baltimore, Md.) Md.), 1994-11, Vol.20 (5), p.1152-1155
• Main Authors: Wright, Teresa L., Hollander, Harry, Pu, Xiang, Held, Michael J., Lipson, Peter, Quan, Stella, Polito, Alan, Thaler, M. Michael, Bacchetti, Peter, Scharschmidt, Bruce F.
• Format: Article
• Language: English
• Subjects: Acquired Immunodeficiency Syndrome - complications; AIDS/HIV; Alanine Transaminase - analysis; Hepatitis C - complications; Hepatitis C - epidemiology; HIV Infections - complications; HIV Infections - mortality; Humans; Male; Prevalence; Retrospective Studies; Risk Factors; RNA, Viral - analysis; Survival Analysis
• ISSN: 0270-9139; 1527-3350
• DOI: 10.1002/hep.1840200508

Background: Limited information is available about the prevalence of hepatitis C virus in patients with human immunodeficiency virus in relation to specific risk factors or about the influence of hepatitis C virus coinfection on survival. This retrospective study addressed these questions. Methods: The study population consisted of 512 predominantly non‐intravenous drug‐using male homosexuals, 224 of whom had AIDS. Samples positive for hepatitis C virus antibody by second‐generation enzyme immunoassay were further tested by means of strip immunoblot assay, and for hepatitis C virus RNA by means of polymerase chain reaction amplification. A randomly selected set of enzyme immunoassay‐negative samples was also tested for hepatitis C virus RNA and, if hepatitis C virus RNA positive, by a second‐generation recombinant immunoblot assay. Results: The prevalence of hepatitis C virus infection unaccounted for by intravenous drug use or transfusion was 11.7% by enzyme immunoassay, and 87% of sera positive by enzyme immunoassay were also positive by second‐generation recombinant immunoblot assay or hepatitis C virus RNA analysis. Hepatitis C virus RNA was detectable in 53% of enzyme immunoassay‐positive samples but in only about 1% of enzyme immunoassay‐negative samples. Hepatitis C virus coinfection did not influence survival of HIV‐infected patients with or without manifestations of AIDS. Conclusions: Hepatitis C virus infection in nontransfused, non‐intravenous drug‐using patients with HIV infection is several times more prevalent than in volunteer blood donors, suggesting homosexual transmission of hepatitis C virus. About half of patients seropositive for hepatitis C virus antibody have detectable hepatitis C virus RNA, and serologically occult hepatitis C virus viremia is rare. Hepatitis C virus coinfection does not appear to adversely influence survival. (Hepatology 1994;20:1152–1155).