Hepatitis C infection and the risk of non-liver-related morbidity and mortality in HIV-positive persons in the Swiss HIV Cohort Study

Abstract

While HCV exposure was associated with an increased risk of kidney disease and osteoporosis/fracture, this risk did not seem to be dependent of persistent HCV RNA. Successful HCV treatment was associated with a lower incidence of liver disease, liver-related death, and diabetes mellitus, whereas the other conditions studied were less affected.

Risk of diabetes in HIV‐infected patients is associated with cirrhosis but not with chronic HCV coinfection in a French nationwide HIV cohort

“…Furthermore, our results are in line with a United States population‐based study reporting that DM was not associated with positive HCV serology or with chronic hepatitis C . Our results are also in keeping with other published data performed among PLHIV …”

“…Cirrhosis could also have been under‐diagnosed, since liver stiffness measured by transient elastometry was only available for 40.2% of HIV/HCV coinfected patients. However, the rate of cirrhosis (18.3%) was similar to that reported in other cohorts of HIV/HCV coinfected patients (17%‐25%) . Furthermore, in robustness analyses using FIB4 as a different non‐ invasive marker of liver fibrosis, we found an independent association between a high FIB4 score (>3.25) and an increased risk of DM (HR 1.86 [95% CI, 1.07‐3.20], P = 0.026).…”

“…In a Spanish cohort of 1625 HIV/HCV coinfected patients treated with IFN and ribavirin, SVR (n = 592) after a median 5‐year follow‐up was associated with a significant decrease in the hazard ratio for DM (sHR 0.57 [95% CI, 0.35‐0.93] P = 0.024) . In a Swiss cohort, HCV‐treated patients without SVR (n = 281) had a 4‐fold higher risk of DM compared to those with SVR (n = 345) . In our cohort, despite a comparable number of patients with SVR (n = 697) and a longer mean follow‐up of 6.3 ± 3.9 years after HCV SVR, SVR was not found to be associated with DM in the subanalysis performed in the 4004 HIV/HCV coinfected patients.…”

“…In addition, DM has been observed as a side effect during or after interferon (IFN)‐based HCV therapy . Furthermore, a decrease in IR and in the incidence of DM has been observed in HCV‐treated patients who achieved sustained viral response (SVR), but results are conflicting …”

Early emergence of opportunistic infections after starting direct‐acting antiviral drugs in HIV/HCV‐coinfected patients

“…Thus, liver events are largely prevented among HIV/HCV‐coinfected patients with cirrhosis who achieve sustained virological response (SVR) to pegylated interferon plus ribavirin (PegIFN/RBV), having only a residual risk for liver decompensation and hepatocellular carcinoma (HCC) . In addition, it has been reported that SVR following PegIFN/RBV treatment among HIV‐ and HCV‐coinfected patients may reduce the risk of some non‐hepatic events …”