March 18, 2014
This article was reported by Infection Control Today.
Infection Control Today reported that the risk of serious liver disease from hepatitis C virus (HCV) infection is high for HCV/HIV-coinfected patients, regardless of whether they receive antiretroviral therapy (ART). To investigate whether ART slows liver fibrosis connected with HCV, researchers from the Perelman School of Medicine at the University of Pennsylvania (UPenn) reviewed electronic medical records of 4,280 HCV/HIV-coinfected patients who were receiving ART, and 6,079 HCV-only patients treated from 1997 through 2010.
Liver disease presents in two stages: compensated, when the liver can function normally by compensating for damage; and decompensated, when the liver can no longer function normally due to widespread damage. Findings indicated that the coinfected patients had an 80-percent higher rate of decompensated cirrhosis than patients with HCV only. When ART controlled the HIV in coinfected patients, they experienced a 60-percent higher rate of serious liver disease than patients with HCV only. Also, decompensation rates were higher for coinfected patients with advanced liver fibrosis, severe anemia, diabetes, and non-black race.
Vincent Lo Re III, M.D., M.S.C.E., assistant professor of medicine and epidemiology in the Division of Infectious Diseases and Department of Biostatistics and Epidemiology at UPenn, and investigator in the Penn Center for AIDS Research, suggested giving serious consideration to beginning hepatitis C treatment in coinfected patients, especially patients with advanced fibrosis or cirrhosis, to prevent serious liver complications.
The full report, "Hepatic Decompensation in Antiretroviral-Treated Patients Co-Infected With HIV and Hepatitis C Virus Compared With Hepatitis C Virus-Monoinfected Patients: A Cohort Study," was published in the Annals of Internal Medicine (2014; doi:10.7326/M13-1829).
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