oai:HAL:hal-04074291v1
HAL CCSD;Wolters Kluwer
CNRS - Centre national de la recherche scientifique
2023
12/15/2023
International audience; Objective: It is unknown whether HCV-cured people with HIV (PWH) without cirrhosis reached the same mortality risk as HCV-uninfected PWH.
We aimed to compare mortality in PWH cured of HCV by direct-acting antivirals (DAAs) to mortality in individuals with HIV monoinfection.
Design: Nationwide hospital cohort.
Methods: HIV-controlled participants without cirrhosis and HCV-cured by DAAs started between 09/2013 and 09/2020, were matched on age (±5 years), sex, HIV transmission group, AIDS status, and BMI (±1 kg/m 2) to up to ten participants with a virally suppressed HIV monoinfection followed at the time of HCV cure ± 6 months.
Poisson regression models with robust variance estimates were used to compare mortality in both groups after adjusting for confounders.
Results: The analysis included 3961 HCV-cured PWH (G1) and 33 872 HCV-uninfected PWH (G2).
Median follow-up was 3.7 years in G1 (interquartile range (IQR): 2.0-4.6), and 3.3 years in G2.
Median age was 52.0 years (IQR: 47.0–56.0), and 29 116 (77.0%) were men.
There were 150 deaths in G1 (adjusted incidence rate (aIR): 12.2/1000 person-years) and 509 (aIR: 6.3/1000 person-years) in G2, with an incidence rate ratio (IRR): 1.9 [95%CI, 1.4–2.7].
The risk remained elevated 12 months post HCV cure (IRR: 2.4 [95%CI, 1.6–3.5]).
Non-AIDS/nonliver-related malignancy was the most common cause of death in G1 (28 deaths).
Conclusions: Despite HCV cure and HIV viral suppression, after controlling on factors related to mortality, DAA-cured PWH without cirrhosis remain at higher risk of all-cause mortality than people with HIV monoinfection.
A better understanding of the determinants of mortality is needed in this population.
Requena, Maria-Bernarda,Grabar, Sophie,Lanoy, Emilie,Pialoux, Gilles,Billaud, Eric,Duvivier, Claudine,Merle, Philippe,Piroth, Lionel,Tattevin, Pierre,Salmon, Dominique,Weiss, Laurence,Costagliola, Dominique,Lacombe, Karine, 2023, Mortality in hepatitis C virus-cured vs. hepatitis C virus-uninfected people with HIV: a matched analysis in the ANRS CO4 FHDH cohort;Mortalité chez les personnes vivant avec le VIH guéries du VHC par rapport aux personnes non infectées par le VHC : une analyse appariée dans la cohorte ANRS CO4 FHDH, HAL CCSD;Wolters Kluwer