- Poster presentation
- Open Access
Risk factors for end-stage liver disease among HIV and hepatitis C virus co-infected patients in the Spanish VACH Cohort
© Teira et al; licensee BioMed Central Ltd. 2008
- Published: 10 November 2008
- Portal Hypertension
- Chronic Liver Disease
- Hepatic Encephalopathy
- Spontaneous Bacterial Peritonitis
- Hepatorenal Syndrome
There is increasing evidence supporting the hypothesis of a beneficial effect of highly active antiretroviral therapy (HAART) on the evolution and outcome of chronic liver disease (CLD) caused by hepatitis C virus (HCV) in HIV co-infected patients. The relative merit of different drugs or drug classes is, however, less well studied.
We performed a cross-sectional study on the VACH Cohort, a multicenter cohort of HIV-infected individuals in Spain, to ascertain the possible associations between exposure to protease inhibitors (PI) or to non-nucleoside analogues (NAN), and the outcome of HCV CLD. We selected HCV co-infected patients who had ever initiated HAART and who had at least one follow-up visit [treatment evaluable (TE)]. We defined our main "exposure" variable as the total time of treatment with any of, either, PI's or NAN's. We evaluated "outcome" as the occurrence of end stage CLD (ESLD), defined as any of: ascites, oesophageal varices, hepatic encephalopathy, hepatorenal syndrome, portal hypertension, hepatocellular carcinoma, or related diagnoses (i.e. upper gastrointestinal bleeding, spontaneous bacterial peritonitis).
1st CD4 cell count
log10 last viral load
nadir CD4 count*
In conclusion, we found no evidence to support the hypothesis of a different effect of PI's and NAN's on the occurrence of ESLD among HIV and HCV co-infected individuals. Hepatitis B co-infection, more profound immunosupression and older age were associated with this outcome.
This article is published under license to BioMed Central Ltd.