title: Effect of hepatitis C infection on progression of HIV disease and early response to initial antiretroviral therapy.
abstract: OBJECTIVE
  To describe the effect of hepatitis C virus (HCV) on the progression of HIV disease and on early changes in the CD4 cell count and HIV viral load after HAART initiation.
  
  
  METHODS
  Data were from a longitudinal medical records review project conducted in over 100 US medical clinics from 1998 to 2004. We analysed data from HIV-infected patients who received antiretroviral therapy (ART), calculated adjusted hazard ratios describing the hazard of death or progression to an AIDS-defining opportunistic illness (AIDS-OI) associated with prevalent HCV infection, and estimated the change in CD4 cell count and HIV viral load after HAART initiation, stratified by HCV status.
  
  
  RESULTS
  A total of 10 481 HIV-infected individuals were followed for a median of 1.9 years; 19% had HCV. HCV infection was not associated with progression to AIDS-OI or death after controlling for important confounding conditions. Factors significantly confounding the risk of both death and diagnosis of an AIDS-OI were alcoholism, drug-induced hepatitis, and the type of ART prescribed. Acute and chronic hepatitis B infection confounded the risk of AIDS-OI diagnosis. During the 12 months after starting HAART, proportional increases in CD4 cell counts did not differ between HCV-infected and HCV-uninfected individuals. Likewise, the short-term change in viral load did not differ.
  
  
  CONCLUSIONS
  In our cohort, HCV did not increase the risk of death or AIDS-OI, and did not affect the early immunological or virological response to initial HAART. Clinicians should evaluate patients with HCV for other, manageable problems, including alcoholism and other viral hepatitis.
authors.affiliation: Centers for Disease Control and Prevention, National Center for HIV, STD, and TB Prevention, Division of HIV/AIDS Prevention, Surveillance and Epidemiology, 1600 Clifton Road NE, Atlanta, GA 30333, USA. pss0@cdc.gov
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Sullivan
authors.forename: Debra L
authors.initials: DL
authors.lastname: Hanson
authors.forename: Eyasu H
authors.initials: EH
authors.lastname: Teshale
authors.forename: Linda L
authors.initials: LL
authors.lastname: Wotring
authors.forename: John T
authors.initials: JT
authors.lastname: Brooks
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications / Q000453:epidemiology; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D018450:Disease Progression; D004812:Epidemiologic Methods; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000276:immunology / Q000401:mortality; D006509:Hepatitis B / Q000150:complications / Q000453:epidemiology; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000635:transmission; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents