title: Cardiac surgery in patients chronically infected with hepatitis C virus: long-term outcomes and comparison to historical controls and human immunodeficiency virus infection.
abstract: BACKGROUND
  Approximately 2-4 million individuals are chronically infected with hepatitis C (HCV) in the United States. Though several studies have previously examined short and mid-term outcomes for patients with cirrhosis requiring cardiac surgery, no study to date has examined the long-term outcomes of individuals chronically infected with HCV.
  
  
  METHODS
  A retrospective review of 75 patients with HCV and/or HIV infection who underwent cardiac surgery between 1999 and 2011 was undertaken. A control dataset, consisting of all non-HCV or HIV infected individuals from this same time period (N.=1499) was also assembled, and both matched and unmatched data were examined. Propensity matching was used to compare groups. Long-term mortality and short-term morbidity were examined.
  
  
  RESULTS
  Within the HIV and HCV cohorts baseline demographics were generally similar to historic controls. Average MELD Score in the HCV group was 10.1. In comparison with the matched control, the HCV group's survival is significantly worse (P=0.02), a trend not observed in the HIV group. Short-term morbidity was not noted to be different.
  
  
  CONCLUSIONS
  Though carefully selected prior to surgery, and having MELD scores that averaged 10.1, patients with chronic HCV infection tend to do worse than both patients with HIV or matched historical controls following cardiac surgery.
authors.affiliation: Veterans Affairs Medical Center, Washington, DC, USA - gregory.trachiotis@va.gov.
authors.forename: Dominic
authors.initials: D
authors.lastname: Emerson
authors.forename: Kendal
authors.initials: K
authors.lastname: Endicott
authors.forename: Richard
authors.initials: R
authors.lastname: Amdur
authors.forename: Gregory
authors.initials: G
authors.lastname: Trachiotis
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D060085:Coinfection; D016208:Databases, Factual; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D006331:Heart Diseases / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D065386:Historically Controlled Study; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome