Patients co-infected with HIV and HCV more likely to suffer liver decompensation

Main Point:

Despite treatment with antiretroviral therapy (ART), patients co-infected with HIV and hepatitis C virus (HCV) have higher rates of liver decompensation than patients with HCV alone.

Published in:

Annals of Internal Medicine

Study Further:

Up to 30 percent of patients with HIV also are often co-infected with HCV and HCV-related liver complications are an important cause of morbidity in co-infected patients.

It has been suggested that ART slows HCV-associated liver fibrosis. However, whether rates of hepatic decompensation and other severe liver events in co-infected patients receiving ART are similar to those with HCV only remains unclear.

Veterans Affairs researchers compared health records for 4,280 patients co-infected with HIV and HCV who initiated ART with those of 6,079 veterans with HCV only to compare hepatic decompensation rates. Co-infected patients that had HIV RNA levels less than 1,000 copies/ML had a lower rate of hepatic decompensation than those with a lesser degree of HIV suppression. However, the rate was still higher than that of patients with HCV alone. Higher rates of decompensation were seen in co-infected patients receiving ART who had baseline advanced liver fibrosis, severe anemia, diabetes, and were of nonblack race.

Reference:

V. Lo Re, M.J. Kallan, J.P. Tate, A.R. Localio, J.K. Lim, M.B. Goetz, M.B. Klein, D. Rimland, M.C. Rodriguez-Barradas, A.A. Butt, C.L. Gibert, S.T. Brown, L. Park, R. Dubrow, K.R. Reddy, J.R. Kostman, B.L. Strom, and A.C. Justice. Hepatic Decompensation in Antiretroviral-Treated Patients Co-Infected With HIV and Hepatitis C Virus Compared With Hepatitis C Virus–Monoinfected Patients: A Cohort Study. Annals of Internal Medicine (2014), 160 (6), 369-379. http://www.annals.org/article.aspx?doi=10.7326/M13-1829