The effect of hepatitis C on progression to AIDS before and after highly active antiretroviral therapy
| Autor: | Maria Dorrucci, David Vlahov, Alessandro Sinicco, Massimo Giuliani, Mauro Zaccarelli, Catia Valdarchi, Giovanni Rezza, Barbara Suligoi, Patrizio Pezzotti |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Hepatitis C virus Immunology medicine.disease_cause Acquired immunodeficiency syndrome (AIDS) Risk Factors Antiretroviral Therapy Highly Active Internal medicine medicine Humans Immunology and Allergy Prospective Studies Risk factor Seroconversion Sida Acquired Immunodeficiency Syndrome AIDS-Related Opportunistic Infections biology business.industry virus diseases Hepatitis C medicine.disease biology.organism_classification Infectious Diseases Disease Progression Female Viral disease Serostatus business |
| Zdroj: | AIDS. 18:2313-2318 |
| ISSN: | 0269-9370 |
| Popis: | OBJECTIVES: To assess the effect of infection with hepatitis C virus (HCV) on the progression of human immunodeficiency virus (HIV) disease, before and after the introduction of highly active antiretroviral therapy (HAART). METHODS: We used data from a multi-centre prospective study of HIV seroconverters. Survival analyses were performed to compare the progression to AIDS by HCV serostatus in the period before HAART (i.e. June 1991-May 1996) and in the HAART era (i.e. June 1996-June 2001), controlling for duration of HIV infection. RESULTS: Among the 1052 persons enrolled, 595 (56.6%) were co-infected; the median follow-up time was 9.7 years. Adjusting for demographic variables (age at HIV seroconversion and gender), HCV infection had no effect on the progression to AIDS in the pre-HAART era [relative hazard (RH) = 0.84; 95% confidence interval (CI), 0.63-1.11], whereas it increased the risk in the HAART era (RH = 1.77; 95% CI, 1.15-2.73). In the HAART era, the proportion of person-time spent on HAART out of the total time at risk was significantly lower among co-infected persons (30 versus 40% for non-co-infected persons; P-value = 0.001); no significant difference was found for dual-therapy (29 versus 25%, respectively; P-value = 0.205); a significant difference was found for mono-therapy (15 versus 8%, respectively; P-value < 0.001). CONCLUSIONS: HCV infection was not a determinant of HIV disease progression in the pre-HAART era, whereas since the introduction of HAART, co-infected individuals seem to have had a faster disease progression. This may in part be explained by differences in person-time spent on different antiretroviral regimens. |
| Databáze: | OpenAIRE |
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