Differences in clinical features of HIV/HCV co-infected individuals compared with HCV mono-infected individuals in Southern Thailand

Abstract

Objectives HIV/HCV co-infection is associated with more aggressive liver than HCV mono-infection. However, there are limited data in Thailand. This study was done to compare demographic data, basic laboratory results and hepatic fibrosis between HIV/HCV co-infected patients and HCV mono-infected patients in a major tertiary care center in Southern Thailand. Methods This was a cross-sectional single center 2-year retrospective study of HCV-treatment-naïve HIV/HCV co-infected patients and HCV mono-infected patients in Songklanagarind Hospital in Southern Thailand. The records of demographic data, basic laboratory results and hepatic fibrosis information were noted from all eligible patients. Results Data from 151 treatment-naïve HCV infected patients during the years 2018-2019 were collected. 51(34%) patients had HIV/HCV co-infections. Genotype 3a was predominant in HCV mono-infected patients(51%), while genotype 1a was predominant in HIV/HCV co-infected patients(35%). The median BMI in HCV mono-infected patients was higher than in HIV-HCV co-infected patients(23.1, IQR 20.3-24.8 vs 20.7, IQR 18.9-22.1, p<0.001). In multivariate analysis, HIV/HCV co-infected patients had higher alcohol consumption(AOR 24.9, p< 0.001), higher rates of unsafe sex(AOR 18.6, p=0.004) and MSM (AOR 8.48, p=0.006), and higher percents of genotype 1a(AOR 8.48, p=0.006) and HCV-RNA(AOR 2.3, p=0.035), while HIV/HCV co-infected individuals were less likely to be married (AOR 0.02, p<0.001), had higher median BMI(AOR 0.82, p=0.02), a higher rate of hepatic steatosis as assessed by controlled attenuation parameter (CAP)(AOR 0.98, p=0.02) and hepatic fibrosis as assessed by FibroScan 502(AOR 0.91, p<0.001) than HCV mono-infected patients. In HIV/HCV co-infected individuals, hepatic fibrosis as evaluated by liver stiffness measurement was not correlated with level of CD4 in our study. Conclusions HIV/HCV co-infected individuals were associated with genotype 1a, unsafe sex, single status and low BMI, while HCV mono-infected individuals were associated with high CAP and high hepatic fibrosis. Large-scale cohort studies are needed to confirm these results, especially hepatic fibrosis in this era of high-fat food consumption.