Influence of hepatitis C virus infection on HIV-1 disease progression and response to highly active antiretroviral therapy
Influence of hepatitis C virus infection on HIV-1 disease progression and response to highly active antiretroviral therapy
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DOI：
10.1086/432762
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发表时间：
2005-09-15
影响因子：
6.4
通讯作者：
Lundgren, J
中科院分区：
文献类型：
--
作者：
Rockstroh, JK;Mocroft, A;Lundgren, J
Objective.评估EuroSIDA队列中丙型肝炎病毒（HCV）抗体的患病率，沿着开始高效抗逆转录病毒治疗（HAART）患者的生存率、人类免疫缺陷病毒（HIV）-1疾病进展、病毒学应答（血浆HIV-1 RNA载量< 500拷贝/mL）和HCV血清状态下的CD 4细胞计数恢复。5957例患者在入组时或入组前的HCV血清状态可用; 1960例（33%）和3997例（67%）分别为HCV血清阳性和血清阴性。在校正基线时已知的其他预后风险因素后，未观察到获得性免疫缺陷综合征定义疾病或死亡的发生率增加与HCV血清状态之间的相关性（校正后的发生率比[IRR]，0. 97 [95%置信区间{CI}，0. 81 - 1. 16]）。然而，在校正模型中，HCV血清阳性患者的肝病相关死亡发生率大幅增加（IRR，11.71 [95%CI，6.42 - 21.34]）。在2260例已知HCV血清状态的患者中，经校正后，HCV血清阳性和血清阴性患者的病毒学应答无显著差异（相对危险度[ RH]，1.13 [ 95% CI，0.84 - 1.51]）和免疫应答，无论是否测量为增加>= 50% HAART启动后CD 4细胞计数增加>= 50个细胞/mL（RH，0.94 [ 95% CI，0.77 - 1.16]）或增加>= 50个细胞/mL（RH，0.92 [95% CI，0.77-1.11]）。HCV血清状态不影响HIV-1疾病进展的风险，但HCV血清阳性患者的肝病相关死亡风险显著增加。对HAART的总体病毒学和免疫学应答不受HCV血清状态的影响。
Objective. To assess hepatitis C virus (HCV) antibody prevalence in the EuroSIDA cohort, along with survival, human immunodeficiency virus (HIV)-1 disease progression, virologic response (plasma HIV-1 RNA load of < 500 copies/mL), and CD4 cell count recovery by HCV serostatus in patients initiating highly active antiretroviral therapy (HAART).Results. HCV serostatus at or before enrollment was available for 5957 patients; 1960 (33%) and 3997 (67%) were HCV seropositive and seronegative, respectively. No association between an increased incidence of acquired immunodeficiency syndrome-defining illnesses or death and HCV serostatus was seen after adjustment for other prognostic risk factors known at baseline (adjusted incidence rate ratio [IRR], 0.97 [95% confidence interval {CI}, 0.81-1.16]). However, there was a large increase in the incidence of liver disease-related deaths in HCV-seropositive patients in adjusted models (IRR, 11.71 [95% CI, 6.42 - 21.34]). Among 2260 patients of known HCV serostatus initiating HAART, after adjustment, there was no significant difference between HCV-seropositive and - seronegative patients with respect to virologic response ( relative hazard [ RH], 1.13 [ 95% CI, 0.84 - 1.51]) and immunologic response, whether measured as a >= 50% increase (RH, 0.94 [ 95% CI, 0.77 - 1.16]) or a >= 50 cells/mL increase (RH, 0.92 [95% CI, 0.77-1.11]) in CD4 cell count after HAART initiation.Conclusions. HCV serostatus did not affect the risk of HIV-1 disease progression, but the risk of liver diseaserelated deaths was markedly increased in HCV-seropositive patients. The overall virologic and immunologic responses to HAART were not affected by HCV serostatus.