Impact of human immunodeficiency virus infection on the course of hepatitis C virus infection: A meta-analysis

Abstract

AIM:To analyze the influence of human immunodeficiency virus (HIV) infection on the course of hepatitis C virus (HCV) infection. METHODS:We performed a meta-analysis to quantify the effect of HIV co-infection on progressive liver disease in patients with HCV infection. Published studies in the English or Chinese-language medical literature involving cohorts of HIV-negative and -positive patients coinfected with HCV were obtained by searching the PUBMED, EMBASE and CBM. Data were extracted independently from relevant studies by 2 investigators and used in a fixed-effect meta analysis to determine the difference in the course of HCV infection in the 2 groups. RESULTS:Twenty-nine trails involving 16 750 patients were identified including the outcome of histological fibrosis or cirrhosis or de-compensated liver disease or hepatocellular carcinoma or death. These studies yielded a combined adjusted odds ratio (OR) of 3.40 [95% confidence interval (CI) = 2.45 and 4.73]. Of note, studies that examined histological fibrosis/ cirrhosis, decompensated liver disease, hepatocellular carcinoma or death had a pooled OR of 1.47 (95% CI = 1.27 and 1.70), 5.45 (95% CI = 2.54 and 11.71), 0.76 (95% CI = 0.50 and 1.14), and 3.60 (95% CI = 3.12 and 4.15), respectively. CONCLUSION:Without highly active antiretroviral therapies (HAART), HIV accelerates HCV disease progression, including death, histological fibrosis/ cirrhosis and decompensated liver disease. However, the rate of hepatocellular carcinoma is similar in persons who had HCV infection and were positive for HIV or negative for HIV.

Human Immunodeficiency Virus/Hepatitis C Virus (HCV) Co‐infected Patients With Cirrhosis Are No Longer at Higher Risk for Hepatocellular Carcinoma or End‐Stage Liver Disease as Compared to HCV Mono‐infected Patients

“…Dominique Salmon-Ceron, 1,2 * Pierre Nahon, 3,4 * Richard Layese, 5-7 Valérie Bourcier, 3 Philippe Sogni, 2,8 Firouze Bani-Sadr, 9,10 Etienne Audureau, [5][6][7] Laurence Merchadou, 11 François Dabis, 11,12 Linda Wittkop, 11,12 and Françoise Roudot-Thoraval 5-7 ; for the…”

“…In an analysis of subgroups assessing survival, the researchers found also a substantially increased risk of death, ). (10) However, all these studies, which were performed before early access to cART, had significant heterogeneity of outcomes, different numbers of patients in cohorts, bias in the fibrosis staging of patients relying or not on a liver biopsy, bias in the effect of HCV infection duration on progression to severe liver disease, as well as publication bias.…”

“…These findings were confirmed in the recent meta‐analysis by Deng et al including 16,750 patients from 29 trials, who found an overall odds ratio (OR) of 5.45 (95% confidence interval [CI] = 2.54‐11.71) for decompensated liver disease for HIV/HCV co‐infected compared to HCV‐infected patients. In an analysis of subgroups assessing survival, the researchers found also a substantially increased risk of death, 3.60 (95% CI = 3.12‐4.15) …”

Hepatitis C genotype 4: The past, present, and future

“…HCV and HBV coinfection increases the incidence of HCC [81] . Large metaanalyses on patients coinfected with HIV have also shown accelerated disease progression [91,92] . Liver transplantation almost always leads to HCV re infection, as well as accelerated disease progression (compared to nontransplant patients) which may be related to a variety of factors: Chronic HCV infection is observed in liver biopsy after 1 year posttransplantation in 50%90% of patients, whereas cirrhosis is seen in around 20% within 5 years [93,94] .…”

Differential regulation of cytotoxicity pathway discriminating between HIV, HCV mono and co-infection identified by transcriptome profiling of PBMCs

“…Liver fibrosis progresses more rapidly in those patients than in mono-infected ones, resulting in increased rates of cirrhosis and complications such as decompensation and hepatocellular carcinoma (HCC) [4][5][6][7]. Compared to HCV mono-infected patients, co-infected individuals are also less likely to achieve viral clearance, and have higher HCV viral loads and more frequent HCV relapses after anti-HCV therapy [8][9][10][11].…”