Hepatitis C/HIV co-infection is associated with higher mortality in hospitalized patients with Hepatitis C or HIV

Abstract

Up to 10% of all patients with Hepatitis C virus (HCV) infection are co-infected with human immunodeficiency virus (HIV); 25-30% of HIV patients are co-infected with HCV. The aim of this study was to examine the association of HCV/HIV co-infection with outcomes of hospitalized patients compared to those with HCV or HIV monoinfection. Using the 2006 Nationwide Inpatient Sample, patients with HCV or HIV monoinfection or HCV/HIV co-infection were identified using ICD-9-CM codes. We compared liver-related and infection-related admission between the three groups of patients. Multivariate logistic regression was performed to identify independent predictors of in-hospital mortality. A total of 474,843 discharges with HCV monoinfection, 206,758 with HIV monoinfection and 56,304 with HCV/HIV co-infection were included. Liver-related admissions were more common in co-infected patients (15.4%) compared to those with HIV monoinfection (3.3%, P < 0.001). Primary infectious hospitalizations were more common in HIV monoinfection (33.9%) compared to co-infected patients (26%, P < 0.001). HCV/HIV co-infection was associated with higher mortality compared to HCV monoinfection (OR 1.41, 95% CI 1.20-1.65) but not when compared to monoinfected-HIV patients. HCV-associated cirrhosis or complications thereof conferred four times greater mortality risk in patients with HIV (OR 3.96, 95% CI 3.29-4.79). The rate of hospitalization for HCV/HIV co-infected patients (23.5%) was significantly higher than those with HCV (14.8%) or HIV (19.9%) (P < 0.001). HCV/HIV co-infection is associated with significantly higher rates of hospitalization and is a risk factor for in-hospital mortality compared to patients with isolated HCV.

HBV infection is associated with greater mortality in hospitalised patients compared to HCV infection or alcoholic liver disease

“…6 A study using NIS 2006 found significantly higher mortality in HIV-HCV co-infection compared to HCV monoinfection. 7 While neither of these studies looked specifically at HBV inpatient mortality, HBV was associated with higher mortality in both ALD and HCV admissions from 1995 and was associated with higher frequency of hospitalisation in the 2006 data. 6,7 To our knowledge, there has not been a comparison of mortality and other outcomes such as length of stay and costs for HBV, HCV, and ALD from a nationwide representative sample of hospitalised patients.…”

“…7 While neither of these studies looked specifically at HBV inpatient mortality, HBV was associated with higher mortality in both ALD and HCV admissions from 1995 and was associated with higher frequency of hospitalisation in the 2006 data. 6,7 To our knowledge, there has not been a comparison of mortality and other outcomes such as length of stay and costs for HBV, HCV, and ALD from a nationwide representative sample of hospitalised patients. In view of the changing epidemiology of the three diseases, an updated comparison of the relative outcomes and costs of hospitalisations associated with the three groups will be useful to inform healthcare resource utilisation and prediction of future costs.…”

Differences in outpatient care and treatment utilization for patients with HIV/HCV coinfection, HIV, and HCV monoinfection, a cross-sectional study

“…Patients that are dually infected tend to experience accelerated progression of end-stage liver disease leading to increased risk of morbidity and mortality [5,6,19-21]. This distinction is important given their unique, clinical needs.…”

“…While antiretroviral and antiviral therapies are widely recommended for use in patients with coinfection [4], these patients continue to experience poorer health outcomes than those with monoinfection. For instance, these individuals are at increased risk for accelerated progression of liver disease and increased rates of morbidity and mortality [5,6]. …”

HBV/HIV coinfection is associated with poorer outcomes in hospitalized patients with HBV or HIV

“…HBV/HIV coinfection is associated with an increased risk of all‐cause and liver‐related hospitalizations . Prior studies have demonstrated that hepatitis C (HCV)/HIV coinfection increases the risk of in‐hospital liver‐related death, especially among patients with cirrhosis and portal hypertension . A study by Puoti et al .…”