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participating institutions:
Johns Hopkins University AIDS Service, New York State DOH AIDS Institute, The CORE Center, Cook County Hospital



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Mortality Among Human Immunodeficiency Virus-Infected Patients with Cirrhosis or Hepatocellular Carcinoma Due to Hepatitis C Virus in French Departments of Internal Medicine/Infectious Diseases, in 1995 and 1997 [Cacoub P et al. CID 2001;32:1207]: This is a report from France concerning two retrospective multicenter cohort surveys that included 17,487 HIV infected patients during 1995 and 26,497 in 1997. The survey indicated a dramatic decrease in AIDS-related annual mortality: 7.4% in 1995 down to 1.7% in 1997. The prevalence of HCV among HIV-infected patients was about 17%. The total deaths in 1997 was 543, including 459 (1.7%) attributed to AIDS and 30 (0.13%) attributed to cirrhosis or hepatocellular carcinoma. Unlike HIV, there was no decrease in mortality rates for 1997 compared to 1995.
Comment: HCV co-infection is obviously a hot topic at the present time, but there are no guidelines for management. It seems clear that HCV progresses more rapidly in the presence of HIV infection; it is unclear if HCV co-infection has any important influence on the rate of HIV progression. The major controversy concerns the indications for HCV therapy, which now usually consists of PEG interferon combined with ribavirin, but indications are often vague. According to the data presented here, the annual death rate for HCV-related cirrhosis and liver cancer were only 0.06% and 0.07% in 1995 and 1997, respectively.
posted 5/17/2001





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