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. 2023 Jul 1;37(8):1297-1306.
doi: 10.1097/QAD.0000000000003569. Epub 2023 Apr 5.

Mortality in hepatitis C virus-cured vs. hepatitis C virus-uninfected people with HIV

Maria-Bernarda Requena  1 , Sophie Grabar  1   2 , Emilie Lanoy  1 , Gilles Pialoux  3 , Eric Billaud  4 , Claudine Duvivier  5 , Philippe Merle  6 , Lionel Piroth  7 , Pierre Tattevin  8 , Dominique Salmon  9 , Laurence Weiss  9 , Dominique Costagliola  1 , Karine Lacombe  1   10
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Free article

Mortality in hepatitis C virus-cured vs. hepatitis C virus-uninfected people with HIV

Maria-Bernarda Requena et al. AIDS. .
Free article

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 (±5 years), sex, HIV transmission group, AIDS status, and body mass index (BMI) (±1 kg/m 2 ) to up to 10 participants with a virally suppressed HIV monoinfection followed at the time of HCV cure ±6 months. 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 3.7 years in G1 [interquartile range (IQR): 2.0-4.6], and 3.3 years (IQR: 1.7-4.4) in G2. Median age was 52.0 years (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 12 months 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.

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