Table of Contents
ISRN Gastroenterology
Volume 2014, Article ID 764540, 7 pages
http://dx.doi.org/10.1155/2014/764540
Research Article

Predictors of Mortality among United States Veterans with Human Immunodeficiency Virus and Hepatitis C Virus Coinfection

1Department of Medicine, Division of Hospital Medicine, Weill Cornell Medical College, 525 East 68th Street, P.O. Box 130, New York, NY 10065, USA
2VA Pittsburgh Health Care System, Pittsburgh, PA 15213, USA
3Department of Medicine, Yale School of Medicine, New Haven, CT 06510, USA
4Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
5Department of Medicine, Sheikh Khalifa Medical City, Abu Dhabi, UAE
6Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA

Received 4 January 2014; Accepted 6 February 2014; Published 7 April 2014

Academic Editors: L. Rodrigo and H. Yoshiji

Copyright © 2014 Sebhat Erqou et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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 (70.4–77.9) per 1000 person-years (PY) among veterans with HIV/HCV coinfection and 39.8 (36.3–43.6) 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 (1.36–1.84). Positive predictors of mortality included decompensated liver disease (2.33 (1.98–2.74)), coronary artery disease (1.74 (1.32–2.28)), chronic kidney disease (1.62 (1.36–1.92)), and anemia (1.58 (1.31–1.89)). Factors associated with reduced mortality included HCV treatment (0.41 (0.27–0.63)) and higher CD4 count (0.90 (0.87–0.93) per 100 cells/μL 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.