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Liver disease progression high among HCV, HIV/HCV coinfected drug users
A high rate of clinical liver disease progression was found in both patients infected with hepatitis C virus and coinfected with HIV and HCV that differed based on patient gender, according to recent research.
“We found a higher rate of clinical liver disease progression in a cohort of HCV mono- and HIV/HCV coinfected drug users than has been previously reported,” Amy S. Baranoski, MD, MSc, from the division of infectious diseases and HIV medicine at Drexel University College of Medicine, and colleagues wrote in their study. “Risk of liver disease progression was primarily associated with HIV infection in persons with a baseline CD4 count less than 200 cells/mm3, and it appears that women with advanced immune suppression may be at higher risk for liver disease progression compared to men.”
Baranoski and colleagues used unadjusted and multivariate analyses to evaluate patients with HCV (n = 143) and HIV/HCV coinfection (n = 421). Of these, 55 patients showed clinical liver disease progression, which consisted of 25.3 events per 1,000 person-years.
The researchers found gender played a factor in clinical liver disease progression; Men coinfected with HIV and HCV had a significantly higher risk for liver disease compared with HCV-infected men (HR = 2.86; 95% CI, 1.23-6.65), the risk was higher among women coinfected with HIV and HCV and CD4 counts less than 200 cells/mm3 compared with women infected with HCV alone (HR = 9.99; 95% CI, 1.84-54.31). In addition, white women had a greater risk for clinical liver disease progression than nonwhite women (HR = 2.84; 95% CI, 0.93-8.68).
“Our results suggest that advanced HIV-associated immune suppression, and not HIV infection alone, is the primary risk factor for clinical liver disease progression in HIV/HCV coinfected drug users,” the researchers concluded. – by Jeff Craven
Disclosure: The researchers report no relevant financial disclosures.