Liver Disease Is Now a Leading Cause of Death among HIV-HCV Coinfected Patients and Is Becoming an Important Cause of Death among HIV-HBV Coinfected Patients

In a multi-center study, French researchers analyzed the characteristics of HIV-infected patients who died from liver disease, focusing on hepatitis virus co-infection.

One-hundred and eighty-five French hospital departments involved in HIV/AIDS management prospectively notified all deaths occurring in 2000. Patients whose hepatitis C (HCV) and hepatitis B (HBV) serostatus was known were classified as being infected by HCV alone, HBV alone (HBsAg positive), both HCV and HBV, or neither HCV nor HBV.

Results

·         Among 822 HIV-infected patients, 29% were infected by HCV alone, 8% by HBV alone, and 4% by both HCV and HBV.

·         The most frequent causes of death were liver disease (31% of cases) and AIDS (29%) among HIV–HCV co-infected patients, and AIDS (38%) and liver disease (22%) among HIV-HBV co-infected patients.

·         Liver disease was a more frequent cause of death among patients co-infected by both HCV and HBV (44% of cases).

·         Hepatocarcinoma was present in 15% of patients who died from liver disease, and was associated with HBV co-infection.

·         Nearly half the patients who died from liver disease had more than 200 CD4/mm3.

Conclusions

Liver disease is now a leading cause of death among HIV-HCV co-infected patients and is becoming an important cause of death among HIV-HBV co-infected patients. The risk of death from liver disease is highest in patients coinfected by both HCV and HBV.

06/03/05

Reference
D Salmon-Ceron and others. Liver disease as a major cause of death among HIV infected patients: role of hepatitis C and B viruses and alcohol. Journal of Hepatology 42(6): 799-805. June 2005.