P-E10 The effect of HCV co-infection on the rate of development of complications among HIV Infected elite controllers

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Abstract

Background:

Elite controllers are HIV-infected patients capable of naturally suppressing HIV-1 to undetectable levels without therapy. Approximately 20% of people infected with HIV are co-infected with hepatitis C (HCV). The purpose of this study was to estimate the effect of HCV co-infection among HIV infected individuals on the time to the development of complications compared to HIV mono-infected individuals.

Methods:

A retrospective cohort study of the Institute of Human Virology elite controller cohort was conducted to estimate the relationship between HCV co-infection and the rate of complications.

Results:

Of the 65 elite controller patients enrolled in the NVS cohort since 2004, 55 were included in the study sample. 25 (45%) patients were HIV/HCV co-infected and 30 (55%) were HIV mono-infected. Patients co-infected with HCV experienced significantly more complications than HIV mono-infected patients (P = 0.002). Patients co-infected with HCV had 4.35 (95% CI: 1.56 to 12.19) times the hazard for the development of complications compared to HIV mono-infected patients (there was no significant difference when HCV related complications were excluded). After controlling immune activation (cellular and sCD14), patients co-infected with HCV experienced complications at 3.47 (1.20 to 10.05) times the rate of HIV mono-infected patients.

Discussion:

HCV co-infected patients experience complications at significantly higher rates compared to HIV mono-infected patients after controlling for immune activation. HCV and/or HAART therapy may prove beneficial in decreasing morbidity and mortality rates in these patients, particularly among those co-infected with HCV.

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