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Hepatitis C infection and the risk of non-liver-related morbidity and mortality in HIV-positive persons in the Swiss HIV Cohort Study.

Type of publication Peer-reviewed
Publikationsform Original article (peer-reviewed)
Author Kovari Helen, Rauch Andri, Kouyos Roger, Rougemont Mathieu, Cavassini Matthias, Schmid Patrick, Stöckle Marcel, Bernasconi Enos, Weber Rainer, Ledergerber Bruno, Swiss HIV Cohort Study,
Project Swiss HIV Cohort Study (SHCS)
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Original article (peer-reviewed)

Journal Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
Page(s) 0
Title of proceedings Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
DOI 10.1093/cid/ciw809

Abstract

HCV infection has been associated with increased non-liver-related morbidity and mortality. However, studies have yielded inconsistent results. The incidence of clinical events in HIV-infected HCV-seropositive and incidence-density-matched HCV-seronegative participants of the Swiss HIV Cohort Study from 08/1994 to 12/2014 was studied. We compared firstly, HCV-seropositive with HCV-seronegative participants, and secondly, HCV-viremic with successfully treated nonviremic patients. Poisson regression was used to assess differences between these groups. We included 2503 HCV-seropositive participants, 540 with spontaneous HCV-clearance, 1294 untreated HCV-RNA-positive, 345 treated with SVR, 281 treated without SVR, and 2503 HCV-seronegative controls. After a mean follow-up of 8.2 years, we observed 107/18 (HCV-seropositive/HCV-seronegative) liver events, 41/14 kidney events, 230/121 osteoporosis/fractures, 82/94 diabetes mellitus, 114/129 cardiovascular events, 119/147 non-AIDS malignancies, 162/126 HIVCDC B/C events, 106/10 liver-related deaths, and 227/218 non-liver-related deaths. Compared to HCV-negative controls, HCV-seropositive participants had an increased risk of liver events (IRR 6.29[95% CI 3.52-11.22]), liver-related death (8.24[3.61-18.83]), kidney events (2.43[1.11-5.33]), and osteoporosis/fracture (1.43[1.03-2.01]). Among HCV-seropositive individuals, treated participants without SVR versus those with SVR had a higher risk of liver events (6.79[2.33-19.81]), liver-related death (3.29[1.35-8.05]), and diabetes mellitus (4.62[1.53-13.96]). Similar but not statistically significant differences were found between untreated HCV-RNA positive patients and those with SVR. While HCV-exposure was associated with an increased risk of kidney disease and osteoporosis/fracture, this risk did not seem to be dependent of persistent HCV-RNA. Successful HCV treatment was associated with a lower incidence of liver disease, liver-related death and diabetes mellitus while the other conditions studied were less affected.
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