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Hepatitis C co-infection does not increase the risk of
cardiovascular diseases or non-AIDS-related cancers among people living with HIV, an badysis of
the large Eurosida cohort published in Clinical Infectious Diseases found.
Although the long-term impact of hepatitis C virus (HCV) infection on risk
end-stage liver disease in HIV-positive people is well established, the
the long-term impact of HCV coinfection on the risk of cardiovascular disease or
cancers that do not define AIDS are uncertain. The risks of cardiovascular disease or
cancers such as non-Hodgkin's lymphoma, pancreatic cancer or cholangiocarcinoma are
high in people with HCV mono-infection, but the effect of HCV infection on
these risks for people living with HIV are unknown.
In addition, studies that have identified increased risks
of certain conditions in people with HCV have been made in various populations
with relatively small sample sizes. The Eurosida cohort is a large cohort
collects comprehensive information on people living with HIV in Europe and
Argentina.
The badysis focused on the risk of cardiovascular disease,
non-AIDS malignancies and terminal liver failure in people living with HIV and HCV
antibodies, compared to people living with HIV alone.
The badysis distinguished four groups of people
anti-HCV antibodies: people who had spontaneously cleared HCV
chronic HCV infection untreated, cured of HCV by any treatment and
people with chronic HCV who have not been cured by treatment.
The badysis included all patients with known anti-HCV antibodies and
RNA status monitored in participating cohorts as of January 2001, a total of
16,818 people. Sixty-two percent were negative for anti-HCV antibodies, 5.5% had disappeared
HCV spontaneously, 22.3% were chronically infected with HCV but untreated, 4.9%
cured of HCV infection and 5.2% had failed HCV treatment.
About three quarters (74%) were men and 85% were white men.
and 83% had been exposed to antiretroviral therapy, 67.8% had HIV viral load
less than 500 copies / ml (undetectable) at the beginning of the follow-up period.
Injection drug users accounted for 25.7% of the entire cohort
but formed the majority in all groups positive for anti-HCV antibodies.
Advanced liver fibrosis
(stage 3 or 4) was the most common in patients who had already undergone treatment
failure (18.2%) or those who recovered from HCV infection (19%).
Participants were followed for a median of 8.3 years. during
During the follow-up period, the most common clinical events were non-AIDS events.
cancers (902 cases, most often bad cancer, representing 15.9% of all
malignancies and lung cancer, with 10.6%) and cardiovascular events (887
case, invasive cardiovascular intervention most often (39.6%) or stroke
(28.1%)).
The incidence rate of cardiovascular disease was 6.4
per 1,000 person-years of follow-up, and the incidence of CVD was slightly higher in
Negative people for HCV and in people who had cared for hepatitis C spontaneously.
The incidence rate of non-AIDS defining cancers was 6.5%
1,000 person-years of follow-up with no significant difference between the
incidence rate of groups.
The incidence rate of terminal liver disease was 3.1%.
1,000 person-years of follow-up. The highest rates of end-stage liver disease
in untreated groups (9.6 per 1000) and treatment failure (9.9 per cent).
1000 p.y.) (both p <0.0001).
People cured of hepatitis C by treatment had not
significantly lower rate of cardiovascular disease, or heart attack or stroke
when the results have been broken down by CVD event. The same was true for
malignancies do not define AIDS, and the investigators also found that the type
HCV treatment that people had received had no effect on these results, regardless
whether the treatment resulted in a cure or not.
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