Mortality due to hepatitis C-related liver disease in HIV-infected patients in France (Mortavic 2001 study).
OBJECTIVE
To determine mortality due to end-stage liver disease (ESLD) in a nationwide cohort of HIV-infected patients 5 years after the introduction of highly active antretroviral therapy (HAART) and to compare this with that observed before and during the early years of HAART.


METHODS
and methods: All departments of internal medicine and infectious diseases from the GERMIVIC Study Group prospectively recorded all deaths in HIV-infected patients during 2001. Sixty-five departments, following a total of 25 178 HIV-infected patients, participated in the study. Results were compared with those of previous surveys conducted using similar methodology in 1995 and 1997.


RESULTS
Among 265 deaths observed during 2001, 129 (48.7%) were related to AIDS, 38 (14.3%) to ESLD, and 98 (36.7%) to other causes. Mortality due to ESLD represented 28% of non AIDS-related deaths; 36 of the 38 patients (95%) dying from ESLD had chronic hepatitis C virus (HCV) infection. In 2001, deaths due to ESLD (14.3%) were significantly more frequent than in 1995 (1.5%; P < 0.01) and 1997 (6.6%; P < 0.01). During this interval, the prevalence of hepatocellular carcinoma as a cause of death increased (1995, 4.7%; 1997, 11%; 2001, 25%; P < 0.05), as did alcohol consumption (P < 0.01).


CONCLUSIONS
In the post-HAART era, ESLD due to HCV is a growing cause of mortality in HIV-infected patients. Increased longevity attributable to HAART, and a higher prevalence of alcohol consumption, are probably involved in this trend.
Rosenthal
Eric
E
Service d'Hématologie Clinique, Hôpital Archet, Nice, France.
Poirée
Marilyne
M
Pradier
Christian
C
Perronne
Christian
C
Salmon-Ceron
Dominique
D
Geffray
Loic
L
Myers
Robert P
RP
Morlat
Philippe
P
Pialoux
Gilles
G
Pol
Stanislas
S
Cacoub
Patrice
P
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D016009:Chi-Square Distribution; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000188:drug therapy / Q000401:mortality* / Q000821:virology; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000401:mortality* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011446:Prospective Studies; D018709:Statistics, Nonparametric
D019380:Anti-HIV Agents