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ISSN: 1734-1922
Archives of Medical Science
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3/2018
vol. 14
 
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abstract:
Public health

Hepatitis C coinfection adversely affects the life expectancy of people living with HIV in northwestern Poland

Magdalena Leszczyszyn-Pynka, Piotr Ciejak, Katarzyna Maciejewska, Magdalena Witak-Jędra, Malwina Karasińska-Cieślak, Ewa Karpińska, Marta Wawrzynowicz-Syczewska, Miłosz Parczewski

Arch Med Sci 2018; 14, 3: 554–559
Online publish date: 2016/03/23
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Introduction
Hepatitis C (HCV) infection adversely affects survival among people living with HIV, increasing mortality risk due to liver-related causes. In Poland HCV is found among ~30% of HIV infected individuals, with only a small percentage successfully treated for this coinfection. This study aimed to analyze the HCV-associated influence on the life expectancy among HIV/HCV coinfected patients from northwestern Poland.

Material and methods
Longitudinal data of 701 (368 HIV monoinfected and 368 HIV/HCV coinfected) patients were investigated to assess the life expectancy and survival after HIV diagnosis. Kaplan-Meier and Cox analyses were used to assess the mortality risk in both unadjusted and multivariate models. Effect plots indicate the adjusted hazard ratio for HCV-associated survival.

Results
Overall mortality was significantly higher among HCV coinfected (22.52%) compared to HIV monoinfected (10.32%) cases (p < 0.001, OR = 2.52 (95% CI: 1.65–3.85)), with shorter life expectancy among HIV/HCV infected patients (median: 55.4 (IQR: 42.8–59.1) years) compared to HIV monoinfection (median 72.7 (IQR: 60.4–76.8) years, univariate HR = 4.15 (95% CI: 2.7–6.38), p < 0.0001, adjusted HR = 2.32 (95% CI: 1.47–3.65), p < 0.0001). After HIV diagnosis, HCV adversely influenced the survival after 15 years of follow-up, with a strengthened impact in the subsequent 5 years (univariate HR = 1.57 (95% CI: 1.05–2.34) p = 0.026 for the 20-year survival time point, adjusted HR = 2.21 (95% CI: 1.18–4.13), p = 0.013).

Conclusions
Among patients living with HIV, HCV coinfection is associated with a median life expectancy decrease of 17.3 years and low probability of surviving until the age of 65 years. In the era of directly acting anti-HCV drugs, treatment scale-up and immediacy of treatment are advisable in this cohort.

keywords:

HIV/HCV coinfection, mortality, hepatitis C virus treatment

references:
Peters L, Mocroft A, Lundgren J, Grint D, Kirk O, Rockstroh J. HIV and hepatitis C co-infection in Europe, Israel and Argentina: a EuroSIDA perspective. BMC Infect Dis 2014; 14 Suppl. 6: S13.
Grzeszczuk A, Wandalowicz AD, Jaroszewicz J, Flisiak R. Prevalence and risk factors of HCV/HIV co-infection and HCV genotype distribution in North-Eastern Poland. Hepat Mon 2015; 15: e27740.
Kaplan-Lewis E, Fierer DS. Acute HCV in HIV-infected MSM: modes of acquisition, liver fibrosis, and treatment. Curr HIV/AIDS Rep 2015; 12: 317-25.
Lewden C, Bouteloup V, De Wit S, et al. All-cause mortality in treated HIV-infected adults with CD4 >/=500/mm3 compared with the general population: evidence from a large European observational cohort collaboration. Int J Epidemiol 2012; 41: 433-45.
Hernando V, Perez-Cachafeiro S, Lewden C, et al. All-cause and liver-related mortality in HIV positive subjects compared to the general population: differences by HCV co-infection. J Hepatol 2012; 57: 743-51.
Klein MB, Rollet-Kurhajec KC, Moodie EE, et al. Mortality in HIV-hepatitis C co-infected patients in Canada compared to the general Canadian population (2003-2013). AIDS 2014; 28: 1957-65.
Morlat P, Roussillon C, Henard S, et al. Causes of death among HIV-infected patients in France in 2010 (national survey): trends since 2000. AIDS 2014; 28: 1181-91.
Weber R, Sabin CA, Friis-Moller N, et al. Liver-related deaths in persons infected with the human immunodeficiency virus: the D:A:D study. Arch Intern Med 2006; 166: 1632-41.
Rosinska M, Zielinski A. Recent increase in HIV rate by age, cohort, period analysis of surveillance data suggests changes in HIV epidemiology in Poland. Cent Eur J Public Health 2011; 19: 123-7.
Niedzwiedzka-Stadnik M, Pielacha M, Rosinska M. HIV and AIDS in Poland in 2012. Przegl Epidemiol 2014; 68: 283-9, 383-6.
Flisiak R, Halota W, Tomasiewicz K, Kostrzewska K, Razavi HA, Gower EE. Forecasting the disease burden of chronic hepatitis C virus in Poland. Eur J Gastroenterol Hepatol 2015; 27: 70-6.
Cielniak ISE, Weber-Kaniuk I, Firląg-Burkacka E, Horban A. Predictors of response to chronic hepatitis C therapy in HIV positive patients – data from outpatient clinic in Warsaw, Poland. 14th European Clinical Society Conference, October 19-19, Brussels, Belgium. Abstract PE13/23. 2014.
Jablonowska E, Piekarska A, Koslinska-Berkan E, Omulecka A, Szymanska B, Wojcik K. Sustained virologic response and IL28B single-nucleotide polymorphisms in patients with chronic hepatitis C treated with pegylated interferon alfa and ribavirin. Acta Biochim Pol 2012; 59: 333-7.
Parczewski M, Leszczyszyn-Pynka M, Bander D, Urban­ska A, Stanczak G, Boron-Kaczmarska A. Characteristics of HIV-1 non-B subtype infections in Northwest Poland. J Med Virol 2010; 82: 1306-13.
Parczewski M, Leszczyszyn-Pynka M, Witak-Jedra M, et al. Transmitted HIV drug resistance in antiretroviral-treatment-naive patients from Poland differs by transmission category and subtype. J Antimicrob Chemother 2015; 70: 233-42.
Peters L, Klein MB. Epidemiology of hepatitis C virus in HIV-infected patients. Curr Opin HIV AIDS 2015; 10: 297-302.
Parczewski M, Bander D, Leszczyszyn-Pynka M, et al. Risk of all-cause mortality in HIV infected patients is associated with clinical, immunologic predictors and the CCR5 Delta32 deletion. PLoS One 2011; 6: e22215.
Pinchoff J, Drobnik A, Bornschlegel K, et al. Deaths among people with hepatitis C in New York City, 2000-2011. Clin Infect Dis 2014; 58: 1047-54.
Grint DPL, Kovari H, Rockstroh J, Lacombe K. EuroSIDA and the Swiss HIV Cohort Study in EuroCoord. A Validated Prognostic Score Estimating the Risk of Liver-Related Death Among HIV/HCV Coinfected Individuals. Abstract 637, 22nd Conference on Retroviruses and Opportunistic Infections. 2015.
Rockstroh JK, Peters L, Grint D, et al. Does hepatitis C viremia or genotype predict the risk of mortality in individuals co-infected with HIV? J Hepatol 2013; 59: 213-20.
Smith CJ, Ryom L, Weber R, et al. Trends in underlying causes of death in people with HIV from 1999 to 2011 (D:A:D): a multicohort collaboration. Lancet 2014; 384: 241-8.
Murray M, Hogg RS, Lima VD, et al. The effect of injecting drug use history on disease progression and death among HIV-positive individuals initiating combination antiretroviral therapy: collaborative cohort analysis. HIV Med 2012; 13: 89-97.
Berenguer J, Rodriguez E, Miralles P, et al. Sustained virological response to interferon plus ribavirin reduces non-liver-related mortality in patients coinfected with HIV and hepatitis C virus. Clin Infect Dis 2012; 55: 728-36.
Grint D, Peters L, Rockstroh JK, et al. Liver-related death among HIV/hepatitis C virus-co-infected individuals: implications for the era of directly acting antivirals. AIDS 2015; 29: 1205-15.
EASL Recommendations on treatment of hepatitis C 2015. J Hepatol 2015; 63: 199-236.
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