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. 2023 Aug 1;37(10):1573-1581.
doi: 10.1097/QAD.0000000000003594. Epub 2023 May 9.

Impact of hepatitis C cure on risk of mortality and morbidity in people with HIV after antiretroviral therapy initiation

Mathieu Chalouni  1   2 , Adam Trickey  3 , Suzanne M Ingle  3 , Maria Antonia Sepuvelda  4 , Juan Gonzalez  5 , Andri Rauch  6 , Heidi M Crane  7 , M John Gill  8 , Peter F Rebeiro  9 , Jürgen K Rockstroh  10 , Ricardo A Franco  11 , Giota Touloumi  12 , Didier Neau  13 , Montserrat Laguno  14 , Michaela Rappold  15   16 , Colette Smit  17 , Jonathan A C Sterne  3 , Linda Wittkop  1   2   18 ; Antiretroviral Therapy Cohort Collaboration (ART-CC)
Affiliations

Impact of hepatitis C cure on risk of mortality and morbidity in people with HIV after antiretroviral therapy initiation

Mathieu Chalouni et al. AIDS. .

Abstract

Objective: Hepatitis C virus (HCV) co-infection is associated with increased morbidity and mortality in people with HIV (PWH). Sustained virological response (SVR) decreases the risk of HCV-associated morbidity. We compared mortality, risk of AIDS-defining events, and non-AIDS nonliver (NANL) cancers between HCV-co-infected PWH who reached SVR and mono-infected PWH.

Design: Adult PWH from 21 cohorts in Europe and North America that collected HCV treatment data were eligible if they were HCV-free at the time of ART initiation.

Methods: Up to 10 mono-infected PWH were matched (on age, sex, date of ART start, HIV acquisition route, and being followed at the time of SVR) to each HCV-co-infected PWH who reached SVR. Cox models were used to estimate relative hazards (hazard ratio) of all-cause mortality, AIDS-defining events, and NANL cancers after adjustment.

Results: Among 62 495 PWH, 2756 acquired HCV, of whom 649 reached SVR. For 582 of these, at least one mono-infected PWH could be matched, producing a total of 5062 mono-infected PWH. The estimated hazard ratios comparing HCV-co-infected PWH who reached SVR with mono-infected PWH were 0.29 [95% confidence interval (CI) 0.12-0.73] for mortality, 0.85 [0.42-1.74] for AIDS-defining events, and 1.21 [0.86-1.72] for NANL cancer.

Conclusion: PWH who reached SVR a short time after HCV acquisition were not at higher risk of overall mortality compared with mono-infected PWH. However, the apparent higher risk of NANL cancers in HCV-co-infected PWH who reached SVR after a DAA-based treatment compared with mono-infected PWH, though compatible with a null association, suggests a need for monitoring of those events following SVR.

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Conflict of interest statement

STATEMENTS AND DECLARATIONS

Competing interests: The authors have declared no competing interests relevant to this article.

Figures

Figure 1.
Figure 1.
Flow-chart of the participants from the ART-CC collaboration
Figure 2.
Figure 2.
Cumulative probabilities of overall mortality, AIDS defining events and non-AIDS non-liver-related cancers according to the SVR status in participants from the ART-CC collaboration
See this image and copyright information in PMC

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