HIV Accelerates the Effects of HCV, Despite Effective ART

HIV has long been known to accelerate hepatitis C virus (HCV)-related hepatic fibrosis in coinfected patients, but the effectiveness of antiretroviral therapy (ART) in reversing this association remains unclear. To explore this issue, researchers analyzed data for a cohort of 6079 HCV-monoinfected patients and 4280 HIV/HCV-coinfected patients newly started on ART who received care between 1997 and 2010 at a Veterans Health Administration facility. All were untreated for HCV.

Hepatic decompensation (i.e., ascites, spontaneous bacterial peritonitis, or variceal hemorrhage) occurred in 576 patients during follow-up (mean duration, 8 years) and was associated with baseline advanced hepatic fibrosis, anemia, diabetes, and nonblack race (but not w…