Loading in 2 Seconds...
Loading in 2 Seconds...
Impact of Chronic Hepatitis C Infection on HIV Disease Progression and AIDS-Defining Illnesses: Results from the Wings Clinic Women’s Cohort (WCWC) Study
Impact of Chronic Hepatitis C Infection on HIV Disease Progression and
AIDS-Defining Illnesses: Results from the Wings Clinic Women’s Cohort (WCWC) Study
BabuSriram Maringanti1, Johnson Britto2, Mohammad Mohammad, Stella Medina1, Amy Wilson1, Shirish Barve3, Ruth Carrico1, Paula Peyrani1
1 Division of Infectious Diseases, 2 Department of Medicine-Pediatrics, 3 Division of Gastroenterolgy, University of Louisville, Louisville, KY
MATERIALS AND METHODS (Cont’d)
Introduction: HIV is a chronic disease with many host and viral factors that affect disease progression and clinical outcomes. Other factors such as viral co-infections may also influence disease progression and clinical outcomes. Recently, the convergence of the HIV and Hepatitis C (HCV) epidemics in females have led to concerns regarding the influence of each virus on the progression of each disease. The objective of this study was to examine the impact of HCV co-infection on HIV disease progression and AIDS defining illnesses (ADIs) in HIV infected females.
Methods: This was a retrospective observational study of HIV-infected female patients managed at the Wings Clinic in Louisville, KY from 2006 to 2011. Patients were divided into two groups: those with HIV mono-infection and those with HIV/HCV co-infection. HIV disease progression was evaluated using CD4+ cell count trends between each group over the study period. CDC criteria were used to identify ADIs.
Results: A total of 164 female HIV patients were included in the study. Of these, 41 (25%) were HCV positive, and 123 (75%) were HCV negative. There was no significant difference in ADI between those with HIV alone and those with HIV/HCV co-infection (0.37). There was no significant differences in trends of CD4+ cell count over time for each group.
Conclusion: Our study shows that, in females, HIV/HCV co-infection does not influence HIV disease progression or the development of ADIs. The lack of influence of HCV infection on the progression of HIV disease may be a manifestation of optimal HAART therapy in our population or other unmeasured confounding variables. The need for aggressive therapy of HCV in HIV infected females requires further evaluation.
Table 1. General patient characteristics .
Figure 1: The graph comparing the progression of CD+ cell count each year for Hepatitis C + and Hepatitis C - patients.
Table 2 showing the risk factors for Hepatitis C and non-Hepatitis C patients.
Expanded HIV testing and trends in diagnoses of HIV infection - District of Columbia, 2004-2008. Centers for Disease Control and Prevention (CDC).
Decline in the AIDS and death rates in the EuroSIDA study: an observational study. Mocroft A, Ledergerber B, Katlama C, Kirk O, Reiss P, d'ArminioMonforte A, Knysz B, Dietrich M, Phillips AN, Lundgren JD; EuroSIDA study group
Life expectancy of individuals on combination antiretroviral therapy in high-income countries: a collaborative analysis of 14 cohort studies. Antiretroviral Therapy Cohort Collaboration.
Ghany MG, Strader DB, Thomas DL, Seeff LB, American Association for the Study of Liver Diseases. Diagnosis, management, and treatment of hepatitis C: an update. Hepatology. 2009 Apr;49(4):1335-74.
National Institutes of Health Consensus Development Program. Management of hepatitis C: 2002. NIH. 2002 Jun 10-12:19(1):116
Arch Intern Med 2006 Aug 14-28;166(15):1632
Relationship of chronic hepatitis C infection to rates of AIDS-defining illnesses in a Canadian cohort of HIV seropositive individuals receiving highly active antiretroviral therapy.Raboud J, Anema A, Su D, Klein MB, Zakaryan A, Swan T, Palmer A, Hosein S, Loutfy MR, Machouf N, Montaner JS, Rourke SB, Tsoukas C, Hogg RS, Cooper C; Canadian Observational Cohort (CANOC) Collaboration.
Table 3. Incidence of ADIs between the two groups during the study period.
MATERIALS AND METHODS
Study design and study population:
Wings Clinic Women’s Cohort study is a retrospective observational study of HIV-infected female patients managed at the Wings Clinic in Louisville, KY from 2006 to 2011. Patients were divided into two groups: those with HIV mono-infection and those with HIV/HCV co-infection.
The odds ratio is 1.74 which indicates that patients with ADI had 1.74 times the likelihood of being infected with Hepatitis C. Fischer exact probability is 0.37.