Mortality in siblings of patients coinfected with HIV and hepatitis C virus.
BACKGROUND
Coinfection with hepatitis C virus (HCV) is a poor prognostic factor for human immunodeficiency virus (HIV)-infected patients. We examined whether the increased mortality in these patients is partly explained by a familial excess risk of death.


METHODS
Danish HIV-infected patients who had had at least 1 HCV test were included (n=3531). In addition, 336,652 population control subjects matched for sex, age, and residency were identified from the Danish Civil Registration System. For both HIV-infected patients and population control subjects, we identified all siblings born after 1951, with dates of death or emigration. Siblings of HIV-infected patients were classified according to the patients' HCV serostatus. Survival after age 20 years was compared among the groups of siblings.


RESULTS
We identified 437 siblings of HIV/HCV-coinfected patients, 1856 siblings of HIV-monoinfected patients, and 285,509 siblings of population control subjects. Mortality was substantially higher in siblings of HIV/HCV-coinfected patients than in either siblings of HIV-monoinfected patients (mortality rate ratio [MRR], 2.97 [95% confidence interval {CI}, 1.98-4.45]) or siblings of control subjects (MRR, 4.23 [95% CI, 3.09-5.79]). Siblings of HIV-monoinfected patients had slightly higher mortality (MRR, 1.43 [95% CI, 1.10-1.85]) than siblings of control subjects.


CONCLUSIONS
HCV infection is a marker of familial factors that affect the survival of HIV-infected patients independently of the pathogenicity of HCV.
Hansen
Ann-Brit Eg
AB
Department of Infectious Diseases, Odense University Hospital, DK-5000 Odense C, Denmark. ann-brit.eg.hansen@rh.hosp.dk
Gerstoft
Jan
J
Kronborg
Gitte
G
Pedersen
Court
C
Sorensen
Henrik Toft
HT
Obel
Niels
N
D000328:Adult; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000401:mortality*; D015497:HIV-1 / Q000472:pathogenicity; D016174:Hepacivirus / Q000472:pathogenicity; D006526:Hepatitis C / Q000150:complications* / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D035781:Siblings; D016019:Survival Analysis