HIV does not affect survival rates following chronic hepatitis C treatment, reports Spanish study

A prospective study in Spain found that mortality rates did not differ by HIV serostatus in people with chronic hepatitis C and advanced liver disease who had a sustained virologic response to hepatitis C treatment with direct-acting antivirals.

About This Study

“No impact of HIV coinfection on the mortality in patients with hepatitis C virus infection after sustained virological response” was published online on Sept. 18, 2024, in Clinical Infectious Diseases. The lead author is Jesica Martín-Carmona, M.D., of the Clinical Virology and STIs Group in the Unit of Infectious Diseases and Microbiology at Hospital Universitario de Valme in Seville, Spain, and of other Spanish institutions. Study funders included Gilead Sciences, a manufacturer of HIV drugs.

Key Research Findings

A Spanish multicenter prospective cohort study compared survival rates by HIV serostatus in 1,118 people with chronic hepatitis C and advanced liver fibrosis, 676 of whom were also living with HIV. All participants achieved sustained virologic response to hepatitis C treatment, and 82% of participants living with HIV were virally suppressed. Demographic characteristics were broadly similar between the groups (86% of participants living with HIV were men vs. 72% of the other group, and mean age was 51 vs. 54 years), except for past or present injection drug use, which was reported by 84% of participants living with HIV vs. 36% of the other participants.

More than half of all participants had liver cirrhosis, and 8% of HIV/HCV vs. 3% of HCV-only participants had a decompensated liver. Diabetes was less common in the HIV/HCV than in the HCV-only group (6% vs. 8% of participants).

After a median follow-up of 76 months, with assessments conducted every six months, 10% of participants with hepatitis only and 11% of participants living with HIV died, not a significant difference. A total of 32 deaths were liver-related, constituting 3% of deaths in each group. Two people died of AIDS, and the remaining deaths were due to non-liver cancers, infection, cardiovascular disease, and other issues, with rates similar between the groups.

Discussion Highlights and Implications for Practice

Study limitations reported included a lack of data on potentially confounding lifestyle factors, social determinants of health, and other comorbidities; use of statins or prior HIV treatment regimens; the relatively young age of participants; and the potential for differences to emerge had the follow-up been longer.

Results showed similar survival rates by HIV serostatus among people with chronic hepatitis C. The researchers pointed out that while other studies have had mixed results this may be due to differences in tobacco, alcohol, or other drug use between cohorts. The study authors called for longer-term studies to confirm the current results.

By Barbara Jungwirth