The effect of hepatitis C on progression to AIDS before and after highly active antiretroviral therapy

Maria Dorrucci, Catia Valdarchi, Barbara Suligoi, Mauro Zaccarelli, Alessandro Sinicco, Massimo Giuliani, David Vlahov, Patrizio Pezzotti, Giovanni Rezza

    Research output: Contribution to journalArticle

    Abstract

    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.

    Original languageEnglish (US)
    Pages (from-to)2313-2318
    Number of pages6
    JournalAIDS
    Volume18
    Issue number17
    DOIs
    Publication statusPublished - Nov 19 2004

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    Keywords

    • HAART
    • HCV
    • Progression to AIDS

    ASJC Scopus subject areas

    • Immunology and Allergy
    • Immunology

    Cite this

    Dorrucci, M., Valdarchi, C., Suligoi, B., Zaccarelli, M., Sinicco, A., Giuliani, M., ... Rezza, G. (2004). The effect of hepatitis C on progression to AIDS before and after highly active antiretroviral therapy. AIDS, 18(17), 2313-2318. https://doi.org/10.1097/00002030-200411190-00012