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Risk of developing specific AIDS-defining illnesses in patients coinfected with HIV and hepatitis C virus with or without liver cirrhosis.
Clin Infect Dis. 2009 Aug 15; 49(4):612-22.CI

Abstract

BACKGROUND

There are few data concerning the risk of specific opportunistic diseases in patients with and without hepatitis C virus (HCV) infection. We evaluated the correlation between the occurrence of different AIDS-defining illnesses (ADIs) and chronic HCV infection or HCV-related liver cirrhosis in a large Italian cohort of human immunodeficiency virus (HIV)-infected subjects.

METHODS

Subjects were stratified into 2 groups: patients without HCV coinfection and with persistently normal aminotransferase levels and patients with HCV coinfection. The patients with HCV coinfection were stratified according to the diagnosis of liver cirrhosis. The incidences of new ADIs were calculated as the number of events per 1000 person-years of follow-up. The rates in the 2 groups were compared using a Poisson regression model adjusted for potential confounders.

RESULTS

We observed a total of 496 ADIs among 5397 patients with 25,105 person-years of follow-up (50% tested positive for HCV). HCV coinfection was associated with increased risk of developing an ADI (adjusted relative rate [ARR], 2.61; 95% confidence interval [CI], 1.88-3.61), specifically bacterial infection (ARR, 3.15; 95% CI, 1.76-5.67), HIV-related disease (ARR, 2.68; 95% CI, 1.03-6.97), and mycotic disease (ARR, 3.87; 95% CI, 2.28-6.59) but not non-Hodgkin lymphoma (ARR, 0.88; 95% CI, 0.22-3.48). The rate of mycotic infection, bacterial infection, toxoplasmosis, and HIV-related ADI among patients with cirrhosis were significantly higher than that among HIV-monoinfected patients, and the risk was greater than that estimated for HCV antibody-positive patients without cirrhosis.

CONCLUSIONS

HIV-related bacterial and mycotic infections are strongly associated with positive HCV serostatus and HCV-related cirrhosis. Clinicians should take into account these data when making decisions on initiation of antiretroviral therapy for HCV-coinfected individuals.

Authors+Show Affiliations

Clinic of Infectious and Tropical Diseases, Dept. of Medicine, Surgery and Dentistry, San Paolo Hospital, University of Milan, via A Di Rudinì 8-20142, Milan, Italy. antonella.darminio@unimi.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19591597

Citation

d'Arminio Monforte, Antonella, et al. "Risk of Developing Specific AIDS-defining Illnesses in Patients Coinfected With HIV and Hepatitis C Virus With or Without Liver Cirrhosis." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 49, no. 4, 2009, pp. 612-22.
d'Arminio Monforte A, Cozzi-Lepri A, Castagna A, et al. Risk of developing specific AIDS-defining illnesses in patients coinfected with HIV and hepatitis C virus with or without liver cirrhosis. Clin Infect Dis. 2009;49(4):612-22.
d'Arminio Monforte, A., Cozzi-Lepri, A., Castagna, A., Antinori, A., De Luca, A., Mussini, C., Caputo, S. L., Arlotti, M., Magnani, G., Pellizzer, G., Maggiolo, F., & Puoti, M. (2009). Risk of developing specific AIDS-defining illnesses in patients coinfected with HIV and hepatitis C virus with or without liver cirrhosis. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 49(4), 612-22. https://doi.org/10.1086/603557
d'Arminio Monforte A, et al. Risk of Developing Specific AIDS-defining Illnesses in Patients Coinfected With HIV and Hepatitis C Virus With or Without Liver Cirrhosis. Clin Infect Dis. 2009 Aug 15;49(4):612-22. PubMed PMID: 19591597.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of developing specific AIDS-defining illnesses in patients coinfected with HIV and hepatitis C virus with or without liver cirrhosis. AU - d'Arminio Monforte,Antonella, AU - Cozzi-Lepri,Alessandro, AU - Castagna,Antonella, AU - Antinori,Andrea, AU - De Luca,Andrea, AU - Mussini,Cristina, AU - Caputo,Sergio Lo, AU - Arlotti,Massimo, AU - Magnani,Giacomo, AU - Pellizzer,Gianpietro, AU - Maggiolo,Franco, AU - Puoti,Massimo, AU - ,, PY - 2009/7/14/entrez PY - 2009/7/14/pubmed PY - 2009/9/15/medline SP - 612 EP - 22 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 49 IS - 4 N2 - BACKGROUND: There are few data concerning the risk of specific opportunistic diseases in patients with and without hepatitis C virus (HCV) infection. We evaluated the correlation between the occurrence of different AIDS-defining illnesses (ADIs) and chronic HCV infection or HCV-related liver cirrhosis in a large Italian cohort of human immunodeficiency virus (HIV)-infected subjects. METHODS: Subjects were stratified into 2 groups: patients without HCV coinfection and with persistently normal aminotransferase levels and patients with HCV coinfection. The patients with HCV coinfection were stratified according to the diagnosis of liver cirrhosis. The incidences of new ADIs were calculated as the number of events per 1000 person-years of follow-up. The rates in the 2 groups were compared using a Poisson regression model adjusted for potential confounders. RESULTS: We observed a total of 496 ADIs among 5397 patients with 25,105 person-years of follow-up (50% tested positive for HCV). HCV coinfection was associated with increased risk of developing an ADI (adjusted relative rate [ARR], 2.61; 95% confidence interval [CI], 1.88-3.61), specifically bacterial infection (ARR, 3.15; 95% CI, 1.76-5.67), HIV-related disease (ARR, 2.68; 95% CI, 1.03-6.97), and mycotic disease (ARR, 3.87; 95% CI, 2.28-6.59) but not non-Hodgkin lymphoma (ARR, 0.88; 95% CI, 0.22-3.48). The rate of mycotic infection, bacterial infection, toxoplasmosis, and HIV-related ADI among patients with cirrhosis were significantly higher than that among HIV-monoinfected patients, and the risk was greater than that estimated for HCV antibody-positive patients without cirrhosis. CONCLUSIONS: HIV-related bacterial and mycotic infections are strongly associated with positive HCV serostatus and HCV-related cirrhosis. Clinicians should take into account these data when making decisions on initiation of antiretroviral therapy for HCV-coinfected individuals. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/19591597/Risk_of_developing_specific_AIDS_defining_illnesses_in_patients_coinfected_with_HIV_and_hepatitis_C_virus_with_or_without_liver_cirrhosis_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/603557 DB - PRIME DP - Unbound Medicine ER -