20th June 15:18
HIV+ have lower mortalities when coinfected w/ Hep C (virus hepatitis cirrhosis)
According to this article, HIV positives coinfected with Hep C have
lower mortality rate. There was a study on coinfection with Hep G that
leads to lower mortality for HIV postives. Strange isn't it
considering doctors want to treat Hep C agressively for HIV patients.
A study of patients in U.S. Veterans' Administration hospitals has
found a surprising result: The death rate among patients with both HIV
and hepatitis C was only half that of patients with HIV alone.
The study by Dr. Hashem El-Serag of Houston Veterans Hospital looked
at 16,439 patients with HIV, of whom 4,761 (29 percent) also had
hepatitis C. They had been in the care of a veterans hospital at some
point between October 1991 and September 2000.
It was found that during this period -- which included the peak years
for AIDS deaths -- the death rate of patients with HIV alone was 12.2
percent. But the death rate for patients with hepatitis C as well was
only 6.3 percent.
After controlling for age, gender and disease severity, the imbalance
between death rates was less, but people with hep C coinfection were
still 20 percent less likely to die in any given year.
On the face of it, this is an extraordinary result. Liver failure is
now one of the most common causes of death in people with HIV, and HIV
is known to accelerate the progress of hepatitis C. Normally hep C
causes liver damage (if it does at all) within a time frame of 20 to
30 years, whereas people with HIV as well can develop cirrhosis and
liver failure in less than 10 years.
Other studies have suggested that hepatitis C coinfection leads to
lower CD4 counts.
However, if this study's results hold up, they suggest the possibility
that hep C may do something to the immune system that enables CD4
cells to resist attack by HIV. This is already known to be the case
with a related virus, GBV-C, which used to be called hepatitis G.
Results from the VA system should be treated with care. The system,
which looks after ex-armed forces members, provides a higher standard
of care than many U.S. HIV patients get.
The study also only looked at patients admitted to the hospital, so
may not be typical of healthier people with HIV "out on the street."
It does suggest, however, that while hep C/HIV co-infection is still a
double burden to carry, it might be better to put off hepatitis C
treatment in coinfected people if their livers appear to be healthy
and can deal with HIV medications.