title: Predictors of Mortality among United States Veterans with Human Immunodeficiency Virus and Hepatitis C Virus Coinfection.
abstract: Background. Understanding the predictors of mortality in individuals with human immunodeficiency virus and hepatitis C virus (HIV/HCV) coinfection can be useful in management of these patients. Methods. We used the Electronically Retrieved Cohort of HCV Infected Veterans (ERCHIVES) for these analyses. Multivariate Cox-regression models were used to determine predictors of mortality. Results. Among 8,039 HIV infected veterans, 5251 (65.3%) had HCV coinfection. The all-cause mortality rate was 74.1 (70.4-77.9) per 1000 person-years (PY) among veterans with HIV/HCV coinfection and 39.8 (36.3-43.6) per 1000 PY for veterans with HIV monoinfection. The multivariable adjusted hazard ratio (95% confidence interval) of all-cause mortality for HCV infection was 1.58 (1.36-1.84). Positive predictors of mortality included decompensated liver disease (2.33 (1.98-2.74)), coronary artery disease (1.74 (1.32-2.28)), chronic kidney disease (1.62 (1.36-1.92)), and anemia (1.58 (1.31-1.89)). Factors associated with reduced mortality included HCV treatment (0.41 (0.27-0.63)) and higher CD4 count (0.90 (0.87-0.93) per 100 cells/ μ L higher count). Data were insufficient to make informative analyses of the role of HCV virologic response. Conclusion. HCV coinfection was associated with substantial increased risk of mortality among HIV infected veterans. HCV treatment was associated with significantly lower risk of mortality.
authors.affiliation: Department of Medicine, Division of Hospital Medicine, Weill Cornell Medical College, 525 East 68th Street, P.O. Box 130, New York, NY 10065, USA ; VA Pittsburgh Health Care System, Pittsburgh, PA 15213, USA.
authors.forename: Sebhat
authors.identifier: 0000-0001-6763-3804
authors.initials: S
authors.lastname: Erqou
authors.affiliation: Department of Medicine, Yale School of Medicine, New Haven, CT 06510, USA.
authors.forename: Arpan
authors.identifier: 0000-0002-8408-8075
authors.initials: A
authors.lastname: Mohanty
authors.affiliation: Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Pashtoon
authors.initials: P
authors.lastname: Murtaza Kasi
authors.affiliation: VA Pittsburgh Health Care System, Pittsburgh, PA 15213, USA ; Department of Medicine, Sheikh Khalifa Medical City, Abu Dhabi, UAE ; Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
authors.forename: Adeel A
authors.initials: AA
authors.lastname: Butt