BACKGROUND: It is unclear whether coinfection with hepatitis C virus (HCV) increases mortality in patients with human immunodeficiency virus (HIV) infection during the era of highly active antiretroviral therapy (HAART). With use of a meta-analysis, we estimated the effect of HCV infection on HIV disease progression and overall mortality in the pre-HAART and HAART eras. METHOD: The PubMed and EMBASE databases were searched for studies published through 30 April 2008. Additional studies were identified from cited references. Studies reporting disease progression or mortality among HCV-HIV coinfected patients were selected. Cross-sectional studies, studies without HCV-negative control subjects, and studies involving children and/or patients who had undergone liver transplantation were excluded. Two authors reviewed articles and extracted data on the demographic characteristics of study populations and risk estimates. Meta-regression was used to explore heterogeneity. RESULTS: Ten studies from the pre-HAART era and 27 studies from the HAART era were selected. In the pre-HAART era, the risk ratio for overall mortality among patients with HCV-HIV coinfection, compared with that among patients with HIV infection alone, was 0.68 (95% confidence interval [CI], 0.53-0.87). In the HAART era, the risk ratio was 1.12 (95% CI, 0.82-1.51) for AIDS-defining events and 1.35 (95% CI, 1.11-1.63) for overall mortality among coinfected patients, compared with that among patients with HIV monoinfection. CONCLUSIONS: HCV coinfection did not increase mortality among patients with HIV infection before the introduction of HAART. In contrast, in the HAART era, HCV coinfection, compared with HIV infection alone, increases the risk of mortality, but not the risk of AIDS-defining events. Future studies should determine whether successful treatment of HCV infection could reduce this excess risk of mortality in coinfected patients.
BACKGROUND: It is unclear whether coinfection with hepatitis C virus (HCV) increases mortality in patients with human immunodeficiency virus (HIV) infection during the era of highly active antiretroviral therapy (HAART). With use of a meta-analysis, we estimated the effect of HCV infection on HIV disease progression and overall mortality in the pre-HAART and HAART eras. METHOD: The PubMed and EMBASE databases were searched for studies published through 30 April 2008. Additional studies were identified from cited references. Studies reporting disease progression or mortality among HCV-HIV coinfectedpatients were selected. Cross-sectional studies, studies without HCV-negative control subjects, and studies involving children and/or patients who had undergone liver transplantation were excluded. Two authors reviewed articles and extracted data on the demographic characteristics of study populations and risk estimates. Meta-regression was used to explore heterogeneity. RESULTS: Ten studies from the pre-HAART era and 27 studies from the HAART era were selected. In the pre-HAART era, the risk ratio for overall mortality among patients with HCV-HIV coinfection, compared with that among patients with HIV infection alone, was 0.68 (95% confidence interval [CI], 0.53-0.87). In the HAART era, the risk ratio was 1.12 (95% CI, 0.82-1.51) for AIDS-defining events and 1.35 (95% CI, 1.11-1.63) for overall mortality among coinfected patients, compared with that among patients with HIV monoinfection. CONCLUSIONS:HCV coinfection did not increase mortality among patients with HIV infection before the introduction of HAART. In contrast, in the HAART era, HCV coinfection, compared with HIV infection alone, increases the risk of mortality, but not the risk of AIDS-defining events. Future studies should determine whether successful treatment of HCV infection could reduce this excess risk of mortality in coinfected patients.
Authors: Paula Braitstein; Amy Justice; David R Bangsberg; Benita Yip; Victoria Alfonso; Martin T Schechter; Robert S Hogg; Julio S G Montaner Journal: AIDS Date: 2006-02-14 Impact factor: 4.177
Authors: Norbert Bräu; Mirella Salvatore; Carlos F Ríos-Bedoya; Alberto Fernández-Carbia; Fiorenzo Paronetto; José F Rodríguez-Orengo; Maribel Rodríguez-Torres Journal: J Hepatol Date: 2005-07-27 Impact factor: 25.083
Authors: G Greub; B Ledergerber; M Battegay; P Grob; L Perrin; H Furrer; P Burgisser; P Erb; K Boggian; J C Piffaretti; B Hirschel; P Janin; P Francioli; M Flepp; A Telenti Journal: Lancet Date: 2000-11-25 Impact factor: 79.321
Authors: L Piroth; M Grappin; L Cuzin; Y Mouton; O Bouchard; F Raffi; D Rey; D Peyramond; F Gourdon; C Drobacheff; M L Lombart; F Lucht; J M Besnier; L Bernard; P Chavanet; H Portier Journal: J Viral Hepat Date: 2000-07 Impact factor: 3.728
Authors: T L Wright; H Hollander; X Pu; M J Held; P Lipson; S Quan; A Polito; M M Thaler; P Bacchetti; B F Scharschmidt Journal: Hepatology Date: 1994-11 Impact factor: 17.425
Authors: Angel M Mayor; Maria A Gomez; Diana M Fernandez; Eddy Rios-Olivares; James C Thomas; Robert F Hunter Journal: Am J Trop Med Hyg Date: 2006-02 Impact factor: 2.345
Authors: Helen M Chun; Mollie P Roediger; Katherine Huppler Hullsiek; Chloe L Thio; Brian K Agan; William P Bradley; Sheila A Peel; Linda L Jagodzinski; Amy C Weintrob; Anuradha Ganesan; Glenn Wortmann; Nancy F Crum-Cianflone; Jason D Maguire; Michael L Landrum Journal: J Infect Dis Date: 2011-12-05 Impact factor: 5.226
Authors: Taraz Samandari; Ellen Tedaldi; Carl Armon; Rachel Hart; Joan S Chmiel; John T Brooks; Kate Buchacz Journal: Open Forum Infect Dis Date: 2017-06-10 Impact factor: 3.835
Authors: Julia L Marcus; Wendy A Leyden; Chun R Chao; Lanfang Xu; Charles P Quesenberry; Phyllis C Tien; Daniel B Klein; William J Towner; Michael A Horberg; Michael J Silverberg Journal: AIDS Patient Care STDS Date: 2015-05-18 Impact factor: 5.078
Authors: Daniel Fuster; Debbie M Cheng; Emily K Quinn; David Nunes; Richard Saitz; Jeffrey H Samet; Judith I Tsui Journal: Addiction Date: 2013-10-24 Impact factor: 6.526
Authors: Hannah Fraser; Christinah Mukandavire; Natasha K Martin; Matthew Hickman; Myron S Cohen; William C Miller; Peter Vickerman Journal: Int J Epidemiol Date: 2017-04-01 Impact factor: 7.196
Authors: Jason Grebely; Geert Robaeys; Philip Bruggmann; Alessio Aghemo; Markus Backmund; Julie Bruneau; Jude Byrne; Olav Dalgard; Jordan J Feld; Margaret Hellard; Matthew Hickman; Achim Kautz; Alain Litwin; Andrew R Lloyd; Stefan Mauss; Maria Prins; Tracy Swan; Martin Schaefer; Lynn E Taylor; Gregory J Dore Journal: Int J Drug Policy Date: 2015-07-17