The Impact of HCV Infection Duration on HIV Disease Progression and Response to cART amongst HIV Seroconverters in the UK

UK HIV Seroconverters Cohort, Jamie Inshaw, Clifford Leen, Martin Fisher, Richard Gilson, David Hawkins, Simon Collins, Julie Fox, Ken McLean, Sarah Fidler, Andrew Phillips, Sam Lattimore, Abdel Babiker, Kholoud Porter

Research output: Contribution to journalArticlepeer-review

Abstract

INTRODUCTION: The effect of HCV infection on HIV disease progression remains unclear; the effect of HCV infection duration on HIV disease progression is unknown.

METHODS: We used data from a cohort of HIV seroconverters to investigate the effect of HCV infection duration on time from HIV seroconversion to CD4 <350 cells/mm3, AIDS or death, censoring at the earlier of cART initiation or last clinic visit, adjusting for confounders and splitting data into follow up periods from HIV seroconversion (<2, 2-4 and >4 years). We additionally compared CD4 cell decline following HCV infection to that of mono-infected individuals with similar HIV infection duration by fitting a random effects model. In a separate analysis, we used linear mixed models to we examine the effect of HCV infection and its duration on CD4 increase over 48 weeks following cART.

RESULTS: Of 1655 individuals, 97 (5.9%) were HCV co-infected. HCV<1 year was associated with a higher risk of endpoint in each follow-up period from HIV seroconversion (HR [95% CI] 2.58 [1.51, 4.41], p = 0.001; 3.80 [1.20, 12.03], p = 0.023; 2.03 [0.88, 4.71], p = 0.098 for <2, 2-4 and >4 years respectively), compared to mono-infected individuals. However, we found no evidence of an association for those with HCV>2 years (all p>0.89). Individuals experienced a somewhat greater decrease in CD4 count following HCV infection lasting 13 months, relative to individuals with HIV alone, (estimate = -3.33, 95% CI [-7.29, 0.63] cells/mm3 per month, p = 0.099). Of 1502 initiating cART, 106 (7.1%) were HCV co-infected, with no evidence of HCV duration at cART being associated with immunological response (p = 0.45).

CONCLUSIONS: The impact of HCV co-infection on HIV disease progression appears to be restricted to the first year after HCV infection.

Original languageEnglish
Pages (from-to)e0132772
JournalPLoS ONE
Volume10
Issue number7
DOIs
Publication statusPublished - 30 Jul 2015

Keywords

  • Adult
  • Anti-HIV Agents
  • CD4 Lymphocyte Count
  • Cohort Studies
  • Coinfection
  • Disease Progression
  • Female
  • Great Britain
  • HIV Seropositivity
  • Hepatitis C
  • Humans
  • Male
  • Time Factors
  • Young Adult

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