title: Hepatitis C virus co-infection increases neurocognitive impairment severity and risk of death in treated HIV/AIDS.
abstract: Previous studies have reported that hepatitis C virus (HCV) co-infection worsens neurocognitive status among individuals with human immunodeficiency virus (HIV)-1 infection. We assessed the prevalence of neurologic disorders and the severity of HIV-associated neurocognitive impairment among HIV-infected individuals in two centralized HIV clinics in Alberta, Canada from 1998 to 2010 based on their HCV serostatus. Of 456 HIV-infected persons without concurrent substance abuse, 91 (20.0%) were HCV seropositive. Of 58 neurologic disorders identified in the cohort, HIV/HCV co-infected individuals exhibited a higher prevalence of multiple neurologic disorders compared to HIV-infected individuals (60.4% vs. 46.6%, p<0.05) and a higher frequency of seizures (28.6% vs. 17.8%, p<0.05). Unlike HIV mono-infected persons, the risk of seizures was independent of immune status in HIV/HCV co-infected individuals (p<0.05). Symptomatic HIV-associated neurocognitive disorders (sHAND) were more severe among HIV/HCV co-infected persons (p<0.05). HCV co-infection was associated with an increased mortality rate (24.2% vs. 14.5%, p<0.05) with a mortality hazard ratio of 2.38 after adjusting for demographic and clinical variables. Our results indicate that the presence of HCV co-infection among HIV-infected individuals increased neurologic disease burden and risk of death, underscoring HCV's capacity to affect the nervous system and survival of HIV-infected persons.
authors.affiliation: Department of Medicine, University of Alberta, Edmonton, AB, Canada.
authors.forename: Pornpun
authors.initials: P
authors.lastname: Vivithanaporn
authors.forename: Krista
authors.initials: K
authors.lastname: Nelles
authors.forename: Leah
authors.initials: L
authors.lastname: DeBlock
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Newman
authors.forename: M John
authors.initials: MJ
authors.lastname: Gill
authors.forename: Christopher
authors.initials: C
authors.lastname: Power
mesh_terms: D015526:AIDS Dementia Complex / Q000188:drug therapy / Q000401:mortality*; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D003072:Cognition Disorders / Q000401:mortality* / Q000821:virology*; D015331:Cohort Studies; D060085:Coinfection / Q000401:mortality* / Q000821:virology; D004827:Epilepsy / Q000401:mortality / Q000821:virology; D005260:Female; D019698:Hepatitis C, Chronic / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D019380:Anti-HIV Agents