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Observational Study
. 2025 Apr 30;80(4):835-841.
doi: 10.1093/cid/ciae473.

No Impact of HIV Coinfection on Mortality in Patients With Hepatitis C Virus Infection After Sustained Virological Response

Jesica Martín-Carmona  1   2   3   4 , Anaïs Corma-Gómez  1   2   3 , Francisco Téllez  5 , Dolores Arenga-Barrios  5 , Miriam Serrano-Fuentes  6 , Luis Morano  7   8 , Diana Corona-Mata  3   9   10   11 , Miguel Nicolás Navarrete Lorite  12 , Francisco Jesús Vera-Méndez  13 , Juan Carlos Alados  14 , Rosario Palacios  15 , Ignacio de Los Santos  3   16 , Paloma Geijo  17 , Arkaitz Imaz  18 , Dolores Merino  19 , Sergio Javier Reus-Bañuls  20 , Maria Jose Galindo  21 , Miguel Ángel López-Ruz  22 , Carlos Galera  23 , Juan A Pineda  1   4 , Juan Macías  1   2   3   4
Affiliations
Observational Study

No Impact of HIV Coinfection on Mortality in Patients With Hepatitis C Virus Infection After Sustained Virological Response

Jesica Martín-Carmona et al. Clin Infect Dis. .

Abstract

Background: In patients with hepatitis C virus (HCV) chronic infection and advanced liver disease, the impact of human immunodeficiency virus (HIV) coinfection on the clinical outcome after sustained virological response (SVR) has not been sufficiently clarified. The aim of this study was to compare the mortality after SVR of patients bearing HCV chronic infection and advanced liver fibrosis, with and without HIV coinfection after a prolonged follow-up.

Methods: This was a prospective multicenter cohort study including individuals with HIV/HCV coinfection and patients with HCV monoinfection from Spain, fulfilling (1) liver stiffness (LS) ≥9.5 kPa before treatment, (2) SVR with a direct-acting antiviral-based regimen, and (3) LS measurement available at SVR. The main outcome was overall survival. Mortality attributable to liver disease and nonhepatic causes was also assessed.

Results: A total of 1118 patients were included, of whom 676 (60.5%) had HIV. The median (Q1-Q3) follow-up was 76 (57-83) months. After SVR, 46 (10%) HCV-monoinfected and 74 (11%) HIV/HCV-coinfected patients died. The overall mortality rate (95% CI) was 1.9 (1.6-2.2) per 100 person-years, 1.9 (1.4-2.5) per 100 person-years in patients with HCV monoinfection, and 1.8 (1.6-2.3) per 100 person-years in people with HIV. In the multivariable analysis, HIV coinfection was not associated with shorter survival (hazard ratio, .98; 95% CI, .61-1.58; P = .939).

Conclusions: In patients with HCV chronic infection and advanced fibrosis, HIV coinfection does not reduce the overall survival after SVR.

Clinical trials registration: Clinicaltrials.gov (NCT04460157).

Keywords: HIV; advanced liver fibrosis; hepatitis C virus; mortality; sustained virological response.

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Conflict of interest statement

Potential conflicts of interest . Instituto de Salud Carlos III: Investing in your future (Project PI19/01443), Juan Rodès (grant number JR23/00066), Río Hortega (grant number CM23/00255), Río Hortega (grant number CM22/00176); Gilead Biomedical Research Fellowship program (GLD21_00096); SEIMC (GEHEP-011 project; Servicio Andaluz de salud: Acción B (grant number B-0061-2021), Acción A (grant number A1-0060-2021). All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

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