title: Impact of human immunodeficiency virus infection on the course of hepatitis C virus infection: a meta-analysis.
abstract: OBJECTIVE
  To analyze the influence of human immunodeficiency virus (HIV) infection on the course of hepatitis C virus (HCV) infection.
  
  
  METHODS
  We performed a meta-analysis to quantify the effect of HIV co-infection on progressive liver disease in patients with HCV infection. Published studies in the English or Chinese-language medical literature involving cohorts of HIV-negative and -positive patients coinfected with HCV were obtained by searching the PUBMED, EMBASE and CBM. Data were extracted independently from relevant studies by 2 investigators and used in a fixed-effect meta analysis to determine the difference in the course of HCV infection in the 2 groups.
  
  
  RESULTS
  Twenty-nine trails involving 16750 patients were identified including the outcome of histological fibrosis or cirrhosis or de-compensated liver disease or hepatocellular carcinoma or death. These studies yielded a combined adjusted odds ratio (OR) of 3.40 [95% confidence interval (CI) = 2.45 and 4.73]. Of note, studies that examined histological fibrosis/cirrhosis, decompensated liver disease, hepatocellular carcinoma or death had a pooled OR of 1.47 (95% CI = 1.27 and 1.70), 5.45 (95% CI = 2.54 and 11.71), 0.76 (95% CI = 0.50 and 1.14), and 3.60 (95% CI = 3.12 and 4.15), respectively.
  
  
  CONCLUSIONS
  Without highly active antiretroviral therapies (HAART), HIV accelerates HCV disease progression, including death, histological fibrosis/cirrhosis and decompensated liver disease. However, the rate of hepatocellular carcinoma is similar in persons who had HCV infection and were positive for HIV or negative for HIV.
authors.affiliation: Department of Infectious Diseases, Zhongnan Hospital, Wuhan University, Wuhan, Hubei Province, China.
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Deng
authors.forename: Xi-En
authors.initials: XE
authors.lastname: Gui
authors.forename: Yong-Xi
authors.initials: YX
authors.lastname: Zhang
authors.forename: Shi-Cheng
authors.initials: SC
authors.lastname: Gao
authors.forename: Rong-Rong
authors.initials: RR
authors.lastname: Yang
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000453:epidemiology; D018450:Disease Progression; D015658:HIV Infections / Q000150:complications* / Q000401:mortality; D006526:Hepatitis C / Q000150:complications* / Q000401:mortality / Q000503:physiopathology*; D006801:Humans; D008113:Liver Neoplasms / Q000453:epidemiology; D018579:Patient Selection