Penn Study: Hepatitis C Remains Major Problem for HIV Patients Despite Antiretroviral Therapy
Patients with HIV and Hepatitis C Had 80 Percent Higher Rates of Serious Liver Disease than Hepatitis C Patients
March 17, 2014 - PHILADELPHIA - A new study led by researchers at the Perelman School of Medicine at the University of Pennsylvania has
found that the risk of hepatitis C-associated serious liver disease persists in HIV patients otherwise benefitting from
therapy (ART) to treat HIV.
It has been suggested that ART slows hepatitis C-associated liver fibrosis; however, whether rates of severe liver
complications in patients co-infected with HIV and hepatitis C receiving ART were similar to those with just
hepatitis C remained unclear.
The study, published in the March 18 issue of Annals of Internal Medicine , examinedelectronic medical record dataof 4,280
patients infected with both HIV and chronic hepatitis C virus who were receiving ART, and 6,079 hepatitis C-only
patients receiving care between 1997 and 2010.
It found that the HIV/hepatitis C-co-infected patients had an 80 percent higher rate of decompensated cirrhosis than
hepatitis C-only patients. Even when co-infected patients had controlled HIV virus in response to ART, they still
had a 60 percent higher rate of serious liver disease compared to those with hepatitis C alone.
"Our results suggest that serious consideration should be given to initiating hepatitis C treatment in patients co-infected
with HIV and hepatitis C-particularly among those with advanced liver fibrosis or cirrhosis-in order to try to reduce the
risk of serious, potentially life-threatening liver complications," said the study's lead
author, Vincent Lo Re III, MD, MSCE , assistant professor of
Medicine and Epidemiology in the division of Infectious Diseases and department of Biostatistics and Epidemiology
at Penn, and an investigator in the Penn Center for AIDS Research. "By taking action sooner, we may be able to
reduce the risk of advanced liver disease in co-infected patients."
This Penn-led study is the largest comparison to date of liver-related complications between antiretroviral-treated
HIV/hepatitis C- co-infected patients and those with hepatitis C-alone.
Hepatitis C is a treacherous infection of the liver that can remain clinically dormant for years. The U.S. Centers for
Disease Control and Prevention has reported that hepatitis C is the leading cause of cirrhosis, liver cancer, and the
need for liver transplants in the nation. It is spread through contact with infected blood. Health experts estimate
that more Americans die from it each year than HIV. Co-infection with hepatitis C occurs in 20-30 percent of
patients with HIV infection, likely due to a shared route of infection.
Liver disease usually occurs in two stages: compensated and decompensated. In the earlier, less severe stage, the liver
still can function normally by compensating for the damage. When extensive damage occurs and the liver can no longer
function normally, decompensation occurs. The higher rates of serious liver disease found in co-infected patients
in the Penn-led study were classified as liver decompensation.
The authors also found that rates of decompensation were higher for co-infected patients with advanced liver fibrosis,
severe anemia, diabetes, and non-black race.
In addition to Dr. Lo Re, other Penn co-authors include Michael J. Kallan, MS; A. Russell Localio, PhD; K. Rajender Reddy,
MD; and Jay R. Kostman, MD. Brian L. Strom MD, MPH, formerly Executive Vice Dean for Institutional Affairs at Penn and
now Chancellor of Rutgers Biomedical and Health Sciences, also participated in the investigation.
The study was funded primarily by the National Institute of Allergy and Infectious Diseases (research grant K01 AI070001 to
Dr. Lo Re].
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Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions
of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman
School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of
Pennsylvania Health System, which together form a $4.3 billion enterprise.
The Perelman School of Medicine is currently ranked #2 in U.S. News & World Report's survey of research-oriented medical
schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $479.3
million awarded in the 2011 fiscal year.
The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania
-- recognized as one of the nation's top 10 hospitals by U.S. News & World Report; Penn Presbyterian Medical Center; and Pennsylvania
Hospital - the nation's first hospital, founded in 1751. Penn Medicine also includes additional patient care facilities and services
throughout the Philadelphia region.
Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities.
In fiscal year 2011, Penn Medicine provided $854 million to benefit our community.
Source: Penn Medicine: University of Pennsylvania
http://www.uphs.upenn.edu/news/News_Releases/2014/03/lo_re/
Contact:
Steve Graff
O: 215-349-5653
C: 215-301-5221
"Reproduced with permission - Penn Medicine: University of Pennsylvania"
Penn Medicine: University of Pennsylvania
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