Influence of Human Immunodeficiency Virus Infection on the Course of Hepatitis C Virus Infection: A Meta-Analysis

Studies have shown that rates of liver disease are higher in persons who are coinfected with human immuno-deficiency virus (HIV) and hepatitis C virus (HCV) than they are in persons with HCV alone, but estimates of risk vary widely and are based on data for dissimilar patient populations. We performed a meta-analysis to quantify the effect of HIV coinfection on progressive liver disease in persons with HCV. Eight studies were identified that included outcomes of histological cirrhosis or decompensated liver disease. These studies yielded a combined adjusted relative risk (RR) of 2.92 (95 % confidence interval [CI], 1.70–5.01). Of note, studies that examined decompensated liver disease had a combined RR of 6.14 (95 % CI, 2.86–13.20), whereas studies that examined histological cirrhosis had a pooled RR of 2.07 (95 % CI, 1.40–3.07). There is a significantly elevated RR of severe liver disease in persons who are coinfected with HIV and HCV. This has important implications for timely diagnosis and consideration of treatment in coinfected persons. Hepatitis C virus (HCV) is a significant public health concern; it affects 3.9 million persons in the United States and an estimated 170 million persons worldwide [1, 2]. Those persons with repeated exposure to blood or blood products are at risk for both HIV and HC