Hepatitis C patients with HIV co-infection demonstrate unique liver-related complications and health behaviors compared to HCV mono-infected patients

Background: Most studies of hepatitis C (HCV) and HIV co-infection focus on HIV cohorts, and may not collect data regarding liver-related outcomes. We used data from the Chronic Hepatitis Cohort Study to investigate the impact of HIV on clinical characteristics and mental health in HCV patients. Methods: Patient demographics and clinical status were collected from the electronic health record from date of diagnosis (HCV or HIV/ HCV co-infection) onward. A subgroup provided survey data regarding health-related behaviors and mental health. Chi-square tests and two-sample t-testswere used to compare categorical and continuous variables, respectively, between mono- and co-infected patients. Results: Among 14545 patients, 584 (4.0%) were HIV co-infected. Compared to mono-infected patients, co-infected patients were significantly younger and more likely to be male, African American, low-income, and publicly insured; less likely to see a liver specialist or receive HCV treatment; and demonstrated increased comorbidities, fibrosis/ cirrhosis, hepatocellular carcinoma, and mortality. Among 5008 survey respondents (4885 HCV; 123 HIV/HCV), coinfected patients were significantly more likely to report drug/ alcohol use and sex with multiple partners. Conclusion: HIV co-infection impacts a demographically distinct subset of HCV patients. Despite high rates of HIV treatment, coinfected patients were less likely to see a liver specialist or receive HCV-specific treatment than HCV mono-infected patients. Co-infected patients also demonstrated increased rates of liver complications and mortality, as well as high-risk behaviors