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.
Annals of Internal Medicine
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.
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