Hepatitis C in HIV-infected patients with and without AIDS: prevalence and relationship to patient survival.
BACKGROUND
Limited information is available about the prevalence of hepatitis C virus in patients with human immunodeficiency virus in relation to specific risk factors or about the influence of hepatitis C virus coinfection on survival. This retrospective study addressed these questions.


METHODS
The study population consisted of 512 predominantly non-intravenous drug-using male homosexuals, 224 of whom had AIDS. Samples positive for hepatitis C virus antibody by second-generation enzyme immunoassay were further tested by means of strip immunoblot assay, and for hepatitis C virus RNA by means of polymerase chain reaction amplification. A randomly selected set of enzyme immunoassay-negative samples was also tested for hepatitis C virus RNA and, if hepatitis C virus RNA positive, by a second-generation recombinant immunoblot assay.


RESULTS
The prevalence of hepatitis C virus infection unaccounted for by intravenous drug use or transfusion was 11.7% by enzyme immunoassay, and 87% of sera positive by enzyme immunoassay were also positive by second-generation recombinant immunoblot assay or hepatitis C virus RNA analysis. Hepatitis C virus RNA was detectable in 53% of enzyme immunoassay-positive samples but in only about 1% of enzyme immunoassay-negative samples. Hepatitis C virus coinfection did not influence survival of HIV-infected patients with or without manifestations of AIDS.


CONCLUSIONS
Hepatitis C virus infection in nontransfused, non-intravenous drug-using patients with HIV infection is several times more prevalent than in volunteer blood donors, suggesting homosexual transmission of hepatitis C virus. About half of patients seropositive for hepatitis C virus antibody have detectable hepatitis C virus RNA, and serologically occult hepatitis C virus viremia is rare. Hepatitis C virus coinfection does not appear to adversely influence survival.
Wright
T L
TL
Department of Medicine, University of California, San Francisco 94121.
Hollander
H
H
Pu
X
X
Held
M J
MJ
Lipson
P
P
Quan
S
S
Polito
A
A
Thaler
M M
MM
Bacchetti
P
P
Scharschmidt
B F
BF
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000410:Alanine Transaminase / Q000032:analysis; D015658:HIV Infections / Q000150:complications* / Q000401:mortality; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008297:Male; D015995:Prevalence; D012367:RNA, Viral / Q000032:analysis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis
D012367:RNA, Viral; D000410:Alanine Transaminase