%0 Journal Article
%T Predictors of Mortality among United States Veterans with Human Immunodeficiency Virus and Hepatitis C Virus Coinfection
%A Sebhat Erqou
%A Arpan Mohanty
%A Pashtoon Murtaza Kasi
%A Adeel A. Butt
%J ISRN Gastroenterology
%D 2014
%R 10.1155/2014/764540
%X Background. Understanding the predictors of mortality in individuals with human immunodeficiency virus and hepatitis C virus (HIV/HCV) coinfection can be useful in management of these patients. Methods. We used the Electronically Retrieved Cohort of HCV Infected Veterans (ERCHIVES) for these analyses. Multivariate Cox-regression models were used to determine predictors of mortality. Results. Among 8,039 HIV infected veterans, 5251 (65.3%) had HCV coinfection. The all-cause mortality rate was 74.1 (70.4每77.9) per 1000 person-years (PY) among veterans with HIV/HCV coinfection and 39.8 (36.3每43.6) per 1000 PY for veterans with HIV monoinfection. The multivariable adjusted hazard ratio (95% confidence interval) of all-cause mortality for HCV infection was 1.58 (1.36每1.84). Positive predictors of mortality included decompensated liver disease (2.33 (1.98每2.74)), coronary artery disease (1.74 (1.32每2.28)), chronic kidney disease (1.62 (1.36每1.92)), and anemia (1.58 (1.31每1.89)). Factors associated with reduced mortality included HCV treatment (0.41 (0.27每0.63)) and higher CD4 count (0.90 (0.87每0.93) per 100 cells/米L higher count). Data were insufficient to make informative analyses of the role of HCV virologic response. Conclusion. HCV coinfection was associated with substantial increased risk of mortality among HIV infected veterans. HCV treatment was associated with significantly lower risk of mortality. 1. Background Human immunodeficiency virus (HIV) is an important cause of morbidity and mortality globally. Worldwide, there are approximately 34 million people with HIV infection, 68% of which are in sub-Saharan African countries [1]. In 2010, there were 1.8 million deaths due to HIV/AIDS globally [1]. In the United States, there were about 1.1 million people infected with HIV in 2010 [2], and 16 thousand individuals died of HIV [2]. Approximately 30每40% of HIV infected persons are coinfected with hepatitis C virus (HCV) [3, 4]. This proportion is as high as 70% among individuals who use intravenous drugs [5]. Prior to the advent of highly active antiretroviral therapy (HAART) the outcome of HIV infected individuals has been largely the function of progression to acquired immunodeficiency syndrome (AIDS) and development of opportunistic infections. In the HAART era, the longevity of HIV infected individuals has significantly improved and chronic conditions such as HCV infection are emerging as important factors in morbidity and mortality [6每8]. HIV/HCV coinfected individuals develop the complications of HCV infection (i.e., cirrhosis of liver, end-stage
%U http://www.hindawi.com/journals/isrn.gastroenterology/2014/764540/