Earn 0.25 hours AMA PRA Category 1 credit: Read this article, and click the link at the end to take the post-test.
Patients with HCV-HIV coinfections had significantly higher rates of hepatic decompensation vs. HCV-monoinfected patients, even when they received antiretroviral therapy and maintained low HIV RNA levels, researchers reported online March 17.
Decompensation rates in coinfected patients were significantly higher with concurrent advanced liver fibrosis, diabetes, or severe anemia or if patients were of nonblack race, reported Dr. Vincent Lo Re III of the University of Pennsylvania, Philadelphia, and his associates (Ann. Int. Med. 2014 Mar. 17 [doi:10.7326/M13-1829]).
The researchers conducted a retrospective cohort study of 4,280 Veterans Health Administration patients coinfected with HCV and HIV who initiated antiretroviral therapy (ART) and 6,079 HCV-monoinfected patients. Patients were treated between 1997 and 2010 and were HCV treatment naive.
The incidence of hepatic decompensation was 7.4% among coinfected patients and 4.8% among monoinfected patients at 10 years, the investigators reported. The difference was statistically significant (hazard ratio accounting for competing risks, 1.56; 95% confidence internal, 1.31-1.86), even when coinfected patients maintained HIV RNA levels of less than 1,000 copies/mL (HR, 1.44; 95% CI, 1.05-1.99).