Hepatitis C remains major problem for HIV patients despite antiretroviral therapy
PHILADELPHIA—A new study led by researchers at the Perelman School of Medicine at the University of Pennsylvania has found that the risk of hepatitis C-associated serious liver disease persists in HIV patients otherwise benefiting from antiretroviral therapy (ART) to treat HIV.
It has been suggested that ART slows hepatitis C-associated liver fibrosis; however, whether rates of severe liver complications in patients co-infected with HIV and hepatitis C receiving ART were similar to those with just hepatitis C remained unclear.
The study, published in the March 18 issue of Annals of Internal Medicine, examined electronic medical record data of 4,280 patients infected with both HIV and chronic hepatitis C virus who were receiving ART, and 6,079 hepatitis C-only patients receiving care between 1997 and 2010.
It found that the HIV/hepatitis C-co-infected patients had an 80 percent higher rate of decompensated cirrhosis than hepatitis C-only patients. Even when co-infected patients had controlled HIV virus in response to ART, they still had a 60 percent higher rate of serious liver disease compared to those with hepatitis C alone.
“Our results suggest that serious consideration should be given to initiating hepatitis C treatment in patients co-infected with HIV and hepatitis C—particularly among those with advanced liver fibrosis or cirrhosis—in order to try to reduce the risk of serious, potentially life-threatening liver complications,” said the study’s lead author, Vincent Lo Re III, MD, MSCE, assistant professor of Medicine and Epidemiology in the division of Infectious Diseases and department of Biostatistics and Epidemiology at Penn, and an investigator in the Penn Center for AIDS Research. “By taking action sooner, we may be able to reduce the risk of advanced liver disease in co-infected patients.”
This Penn-led study is the largest comparison to date of liver-related complications between antiretroviral-treated HIV/hepatitis C- co-infected patients and those with hepatitis C-alone.