Mortality in hepatitis C virus-cured vs. hepatitis C virus-uninfected people with HIV.
AIDS
; 37(8): 1297-1306, 2023 07 01.
Article
en En
| MEDLINE
| ID: mdl-37070541
ABSTRACT
OBJECTIVE:
It is unknown whether hepatitis C virus (HCV)-cured people with HIV (PWH) without cirrhosis reached the same mortality risk as HCV-uninfected PWH. We aimed to compare mortality in PWH cured of HCV by direct-acting antivirals (DAAs) to mortality in individuals with HIV monoinfection.DESIGN:
Nationwide hospital cohort.METHODS:
HIV-controlled participants without cirrhosis and HCV-cured by DAAs started between September 2013 and September 2020, were matched on age (±5âyears), sex, HIV transmission group, AIDS status, and body mass index (BMI) (±1âkg/m 2 ) to up to 10 participants with a virally suppressed HIV monoinfection followed at the time of HCV cure ±6âmonths. Poisson regression models with robust variance estimates were used to compare mortality in both groups after adjusting for confounders.RESULTS:
The analysis included 3961 HCV-cured PWH (G1) and 33 872 HCV-uninfected PWH (G2). Median follow-up was 3.7âyears in G1 [interquartile range (IQR) 2.0-4.6], and 3.3âyears (IQR 1.7-4.4) in G2. Median age was 52.0âyears (IQR 47.0-56.0), and 29 116 (77.0%) were men. There were 150 deaths in G1 [adjusted incidence rate (aIR) 12.2/1000 person-years] and 509 (aIR 6.3/1000 person-years) in G2, with an incidence rate ratio (IRR) 1.9 [95% confidence interval (CI), 1.4-2.7]. The risk remained elevated 12âmonths post HCV cure (IRR 2.4 [95% CI, 1.6-3.5]). Non-AIDS/non-liver-related malignancy was the most common cause of death in G1 (28 deaths).CONCLUSIONS:
Despite HCV cure and HIV viral suppression, after controlling on factors related to mortality, DAA-cured PWH without cirrhosis remain at higher risk of all-cause mortality than people with HIV monoinfection. A better understanding of the determinants of mortality is needed in this population.
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Infecciones por VIH
/
Hepatitis C
/
Hepatitis C Crónica
Tipo de estudio:
Prognostic_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
AIDS
Asunto de la revista:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Año:
2023
Tipo del documento:
Article