Mortality in HIV-infected injection drug users with active vs cleared hepatitis C virus-infection: a population-based cohort study

TY - JOUR

T1 - Mortality in HIV-infected injection drug users with active vs cleared hepatitis C virus-infection: a population-based cohort study

AU - Omland, L H

AU - Jepsen, P

AU - Weis, N

AU - Christensen, P B

AU - Laursen, A L

AU - Nielsen, H

AU - Krarup, H

AU - Sørensen, H T

AU - Obel, N

N1 - Keywords: Adult; Cohort Studies; Denmark; Drug Users; Female; HIV Infections; Hepatitis C; Hepatitis Viruses; Humans; Male; Middle Aged; Substance Abuse, Intravenous; Survival Analysis

PY - 2010/4

Y1 - 2010/4

N2 - Acute hepatitis C virus (HCV) infection may lead to chronic HCV-infection with detectable HCV RNA or to spontaneous clearance with no HCV RNA, but detectable HCV antibodies. It is unknown whether HCV RNA status is associated with mortality in HIV-infected injection drug users (IDUs). We conducted a nationwide population-based cohort study to examine the impact of HCV RNA status on overall and cause-specific mortality in HIV-infected IDUs. We computed cumulative mortality and used Cox Regression to estimate mortality rate ratios (MRR). We identified 392 HIV-infected patients of whom 284 (72%) had chronic HCV-infection (HCV RNA positive patients) and 108 (28%) had cleared the HCV-infection (HCV RNA negative patients). During 1286 person-years of observation (PYR), 157 persons died (MR = 122/1000 PYR, 95% CI: 104-143). The estimated 5-year probabilities of survival were 0.58 (95% CI: 0.51-0.65) in the chronically HCV-infected and 0.52 (95% CI: 0.40-0.63) in the cleared HCV group. Chronic HCV-infection was not associated with overall mortality: MRR 0.85, 95% CI: 0.59-1.21. In HIV-infected Danish IDUs, chronic HCV-infection is not associated with increased mortality compared to patients who have cleared the infection.

AB - Acute hepatitis C virus (HCV) infection may lead to chronic HCV-infection with detectable HCV RNA or to spontaneous clearance with no HCV RNA, but detectable HCV antibodies. It is unknown whether HCV RNA status is associated with mortality in HIV-infected injection drug users (IDUs). We conducted a nationwide population-based cohort study to examine the impact of HCV RNA status on overall and cause-specific mortality in HIV-infected IDUs. We computed cumulative mortality and used Cox Regression to estimate mortality rate ratios (MRR). We identified 392 HIV-infected patients of whom 284 (72%) had chronic HCV-infection (HCV RNA positive patients) and 108 (28%) had cleared the HCV-infection (HCV RNA negative patients). During 1286 person-years of observation (PYR), 157 persons died (MR = 122/1000 PYR, 95% CI: 104-143). The estimated 5-year probabilities of survival were 0.58 (95% CI: 0.51-0.65) in the chronically HCV-infected and 0.52 (95% CI: 0.40-0.63) in the cleared HCV group. Chronic HCV-infection was not associated with overall mortality: MRR 0.85, 95% CI: 0.59-1.21. In HIV-infected Danish IDUs, chronic HCV-infection is not associated with increased mortality compared to patients who have cleared the infection.

U2 - 10.1111/j.1365-2893.2009.01175.x

DO - 10.1111/j.1365-2893.2009.01175.x

M3 - Journal article

C2 - 19709359

SN - 1352-0504

VL - 17

SP - 261

EP - 268

JO - Journal of Viral Hepatitis

JF - Journal of Viral Hepatitis

IS - 4

ER -