title: Survival in HIV-infected patients is associated with hepatitis C virus infection and injecting drug use since the use of highly active antiretroviral therapy in the Lyon observational database.
abstract: Highly active antiretroviral therapy (HAART) has reduced the incidence of death in HIV-infected patients but various rates of survival have been reported due to the infection with hepatitis C virus (HCV) and the use of injecting drugs (IDU). A survival analysis was performed to estimate and compare the death rates in HIV-positive patients infected by IDU and/or positive for HCV antibodies in the pre-HAART and HAART periods in Lyon (France) between 1992 and 2002. Patients were stratified into four groups (G): HCV-/IDU-(G1), HCV+/IDU-(G2), HCV+/IDU-(G3), HCV+/IDU+ (G4) and adjusted death rates in the pre-HAART era (< 1996) and the HAART era (> or = 1996) were compared. The aHR of progression to death was 1.05 (95% CI 0.75-1.47, P = 0.75) for G2, 1.09 (95% CI 0.54-2.22, P = 0.81) for G3 and 0.90 (95% CI 0.65-1.24, P =0.51) for G4 compared with G1 in the pre-HAART era. The aHR of progression to death was 0.76 (95% CI 0.28-2.08, P = 0.59) for G2, 1.23 (95% CI 0.17-8.86, P = 0.84) for G3 and 2.90 (95% CI 1.62-5.20, P < 0.001) for G4, compared with G1 in the HAART era. HAART management of HCV+/IDU+ patients needs to be optimized for them to achieve a similar benefit as observed among other individuals.
authors.affiliation: Laboratory of Epidemiology and Public Health and INSERM U271, Lyon, France.
authors.forename: N
authors.initials: N
authors.lastname: Voirin
authors.forename: C
authors.initials: C
authors.lastname: Trépo
authors.forename: P
authors.initials: P
authors.lastname: Miailhes
authors.forename: J L
authors.initials: JL
authors.lastname: Touraine
authors.forename: C
authors.initials: C
authors.lastname: Chidiac
authors.forename: D
authors.initials: D
authors.lastname: Peyramond
authors.forename: J M
authors.initials: JM
authors.lastname: Livrozet
authors.forename: J
authors.initials: J
authors.lastname: Ritter
authors.forename: P
authors.initials: P
authors.lastname: Chevallier
authors.forename: J
authors.initials: J
authors.lastname: Fabry
authors.forename: R
authors.initials: R
authors.lastname: Allard
authors.forename: P
authors.initials: P
authors.lastname: Vanhems
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005602:France; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality*; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology / Q000401:mortality*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D008297:Male; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000453:epidemiology / Q000401:mortality*; D016019:Survival Analysis
chemical_list: D018937:Hepatitis C Antibodies