title: Impact of hepatitis C on survival of HIV-infected individuals in Shiraz; South of Iran.
abstract: BACKGROUND
  HIV and HCV infections are basic issues of many health systems. Since HIV and HCV are transmitted similarly, it is common to become infected by them simultaneously. No consensus exists on the effect of HCV infection on the survival of HIV-infected patients.
  
  
  OBJECTIVE
  This study aimed to investigate the issue in a relatively large cohort of patients who had a high prevalence of this coinfection in Shiraz (South of Iran).
  
  
  METHODS
  In this historical cohort study, we evaluated the survival time of 1338 HIV-infected individuals who had been referred to a behavioral consultation center in Shiraz over 10 years (from April 2001 to July 2011). Kaplan-Meier method and log-rank test were used to investigate patient survival and compare their survival curves, respectively. Moreover, Cox proportional hazards model was used to examine the effect of HCV infection on patient survival after control for age, sex, having the injection drug use (IDU) risk factor, CD4 count at baseline, more than a 30% decline in CD4 cell count, and highly active antiretroviral therapy (HAART).
  
  
  RESULTS
  In our cohort, 1044 patients (78.03%) were infected by HCV. The median follow-up was 43.48 months (95% CI = 61.18-26.63). The median survival time in HCV-infected and uninfected patients was 163.8 and 194.8 months, respectively (P = 0.039). After controlling for other covariates, HCV infection increased the mortality rate 2.13 times more in HCV-infected patients than HCV -uninfected patients (CI: 95%; 1.1-4.52).
  
  
  CONCLUSIONS
  HCV infection increases AIDS-related deaths. To control HCV infection and transmission and eliminate HCV, timely diagnosis and treatment and serious harm reduction programs must be implemented.
authors.affiliation: Research Center for Health Sciences, Epidemiology Department, School of Health and Nutrition, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Rezaianzadeh
authors.forename: Jafar
authors.initials: J
authors.lastname: Hasanzadeh
authors.forename: Abbas
authors.initials: A
authors.lastname: Alipour
authors.forename: Mohamed Ali
authors.initials: MA
authors.lastname: Davarpanah
authors.forename: Abdorreza
authors.initials: A
authors.lastname: Rajaeifard
authors.forename: Seyed Hamid Reza
authors.initials: SH
authors.lastname: Tabatabaee