title: Hepatitis C viral load, genotype 3 and interleukin-28B CC genotype predict mortality in HIV and hepatitis C-coinfected individuals.
abstract: OBJECTIVE
  We hypothesized that hepatitis C virus (HCV) load and genotype may influence all-cause mortality in HIV-HCV-coinfected individuals.
  
  
  METHODS
  Observational prospective cohort study. Mortality rates were compared in a time-updated multivariate Poisson regression analysis.
  
  
  RESULTS
  We included 264 consecutive HIV-HCV-coinfected individuals. During 1143 person years at risk (PYR) 118 individuals died [overall mortality rate 10 (95% confidence interval; 8, 12)/100 PYR]. In multivariate analysis, a 1 log increase in HCV viral load was associated with a 30% higher mortality risk [adjusted mortality rate ratio (aMRR): 1.30 (1.10,1.54)] when adjusted for sex, age, HIV exposure group, CD4 cell count, HIV RNA, HCV genotype and interleukin (IL)-28B genotype. Further, HCV genotype 3 vs. 1 [aMRR: 1.83 (1.12, 2.98)] and HIV RNA [aMRR: 3.14 (1.37,7.17) for undetectable vs. just detectable HIV RNA] were independent predictors of mortality, whereas a higher CD4 cell count was associated with a 41% reduction in mortality rate per 50 cell increase between 0 and 200 cells/μl [aMRR: 0.59 (0.48, 0.72)] and a 10% reduction for increases above 200 cells/μl [aMRR: 0.90 (0.82-0.98)]. IL28B) CC genotype was associated with 54% higher mortality risk [aMRR: 1.54 (0.89, 3.82] compared to TT genotype.
  
  
  CONCLUSIONS
  High-HCV viral load, HCV genotype 3 and IL28B genotype CC had a significant influence on the risk of all-cause mortality among individuals coinfected with HIV-1. This may have consequences for the management of HIV-HCV-coinfected individuals.
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark. louisenygaardclausen@gmail.com
authors.forename: Louise Nygaard
authors.initials: LN
authors.lastname: Clausen
authors.forename: Karen
authors.initials: K
authors.lastname: Astvad
authors.forename: Steen
authors.initials: S
authors.lastname: Ladelund
authors.forename: Mette Vang
authors.initials: MV
authors.lastname: Larsen
authors.forename: Kristian
authors.initials: K
authors.lastname: Schønning
authors.forename: Thomas
authors.initials: T
authors.lastname: Benfield
mesh_terms: D000328:Adult; D000368:Aged; D018791:CD4 Lymphocyte Count; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000401:mortality* / Q000821:virology; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000235:genetics / Q000401:mortality* / Q000821:virology; D006801:Humans; D007372:Interferons; D007378:Interleukins / Q000235:genetics; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood*; D012307:Risk Factors; D019562:Viral Load; D000095022:Interferon Lambda
chemical_list: D007372:Interferons; D007378:Interleukins; D012367:RNA, Viral; C000624353:interferon-lambda, human; D000095022:Interferon Lambda