HIV and HCV Coninfected Have Higher Hepatic Decompensation Rates
Major finding: About 7.4% of coinfected patients and 4.8% of monoinfected patients had hepatic decompensation at 10 years (hazard ratio, 1.56; 95% confidence internal, 1.31-1.86).
Data source: Retrospective cohort study of 4,280 patients coinfected with HCV and HIV who initiated antiretroviral therapy and 6,079 HCV-monoinfected patients treated between 1997 and 2010. Patients were HCV treatment naive.
Disclosures: The study was supported by the National Institutes of Health. Investigator disclosures were not available.
FROM ANNALS OF INTERNAL MEDICINE
The finding suggested that "suppression of HIV RNA with ART is an important factor in slowing progression of HCV-related liver fibrosis," the researchers wrote. "This observation supports current management guidelines that recommend initiation of ART among patients co-infected with HIV and HCV, regardless of CD4 cell count."
Hepatic decompensation in coinfected patients also was significantly associated with baseline advanced hepatic fibrosis, severe anemia (baseline hemoglobin level less than 100 g/L), diabetes mellitus, or being of nonblack race, with hazard ratios ranging between 1.88 and 5.45. "Clinicians should address modifiable risk factors and consider treatment of HCV infection in co-infected patients to reduce rates of hepatic decompensation," Dr. Lo Re and his colleagues wrote.
The study was supported by the National Institutes of Health. Investigator disclosures were not available.
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