Hepatic decompensation higher with HIV, HCV co-infection

(HealthDay)—Patients co-infected with HIV and hepatitis C virus (HCV) have higher rates of hepatic decompensation than those with HCV monoinfection, according to a study published in the March 18 issue of the Annals of Internal Medicine.

Vincent Lo Re III, M.D., from the University of Pennsylvania and the Philadelphia VA Medical Center, and colleagues conducted a retrospective cohort study to compare the incidence of hepatic decompensation between 4,280 antiretroviral-treated patients co-infected with HIV and HCV and 6,079 HCV-monoinfected patients. All patients were HCV treatment-naive and had detectable HCV RNA.

The researchers found that, at 10 years, the incidence of hepatic decompensation was 7.4 percent among co-infected patients and 4.8 percent among monoinfected patients (P < 0.001). Co-infected patients had a higher rate of hepatic decompensation than HCV-monoinfected patients (hazard ratio [HR] accounting for competing risks, 1.56). The rate of decompensation was also higher in co-infected patients who maintained HIV RNA levels <1,000 copies/mL compared with HCV-monoinfected patients (HR, 1.44). Among co-infected patients, higher rates of decompensation were associated with baseline advanced hepatic fibrosis (HR, 5.45 with FIB-4 score >3.25); baseline hemoglobin level <100g/L (HR, 2.24); diabetes mellitus (HR, 1.88); and nonblack race (HR, 2.12).

"Despite receiving antiretroviral therapy, patients co-infected with HIV and HCV had higher rates of hepatic decompensation than HCV-monoinfected patients," the authors write.