Characteristics and survival of AIDS patients with hepatitis C: the Brazilian National Cohort of 1995-1996.
BACKGROUND
As AIDS patients live longer, the management of co-morbidities becomes increasingly important. Previous studies from developed countries give conflicting results as to whether co-infection with hepatitis C virus (HCV) lowers the life expectancy of individuals with AIDS.


METHODS
This retrospective cohort study was based on a medical record review of a nationally representative sample of 2821 adult AIDS cases diagnosed in 1995 and 1996 in Brazil. We compared the characteristics and survival of patients known to be positive and negative for HCV.


RESULTS
A total of 833 patients received HCV testing, and the prevalence was 33%. HCV-positive patients received less intensive antiretroviral treatment. The crude mortality was greater for HCV-positive patients (hazard ratio 1.26; P = 0.04), but HCV status was not a significant predictor in a multivariate analysis that included other predictors of survival.


CONCLUSIONS
Brazilian AIDS patients with hepatitis C have a shorter survival than those without, but this seems to be mainly as a result of their receiving less antiretroviral treatment. We cannot say whether this is because of the fear of hepatotoxicity, an inability to tolerate treatment, or for other reasons. To improve survival, these patients need optimal treatment of their HIV disease.
Marins
José Ricardo Pio
JR
Universidade Estadual de Campinas, Campinas, Brazil. piomarins@aids.gov.br
Barros
Marilisa Berti de Azevedo
MB
Machado
Helymar
H
Chen
Sanny
S
Jamal
Leda Fátima
LF
Hearst
Norman
N
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D000328:Adult; D000367:Age Factors; D019380:Anti-HIV Agents / Q000008:administration & dosage; D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data; D001938:Brazil / Q000453:epidemiology; D018791:CD4 Lymphocyte Count; D004522:Educational Status; D004812:Epidemiologic Methods; D005260:Female; D006526:Hepatitis C / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D012698:Serologic Tests / Q000706:statistics & numerical data; D012737:Sex Factors; D015819:Substance Abuse, Intravenous / Q000150:complications
D019380:Anti-HIV Agents