Chrono-optimal treatments for human immunodeficiency virus/hepatitis C virus co-infection yield comparable survival outcomes with hepatitis C virus mono-infection
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND Over recent decades, treatment for human immunodeficiency virus (HIV)/hepatitis C virus (HCV) co-infection has significantly advanced. HIV is known to accelerate liver disease progression and increase liver-related mortality in patients with HCV infection. AIM To reassess the effectiveness of HCV treatments by comparing outcomes between HIV/HCV co-infected and HCV mono-infected patients. METHODS We retrospectively included patients with HCV mono-infection or HIV/HCV co-infection at 12 tertiary referral centers from January 2009 to December 2020. The primary endpoint was overall survival (OS). Secondary endpoints included achievement of a sustained virologic response (SVR), time-to-occurrence of hepatocellular carcinoma (HCC), and the changes in fibrosis-4 (FIB-4) index. RESULTS A total of 904 patients were included: 792 with HCV mono-infection and 112 with HIV/HCV co-infection, of whom 97 (86.6%) had received prior HIV treatment. HCV treatment was administered to 741 (93.6%) mono-infected and 86 (76.8%) co-infected patients. Among treated patients, SVR was achieved in 93.4% of mono-infected and 81.4% of the co-infected group [P = 0.114 after inverse probability of treatment weighting (IPTW) adjustment]. OS and HCC occurrence showed no significant differences between groups, regardless of the HCV treatment method, after IPTW [hazard ratio (HR) = 0.37, 95% confidence interval (95%CI): 0.05-3.07, P = 0.360 for OS; HR = 0.19, 95%CI: 0.02-1.48, P = 0.113 for HCC occurrence]. The FIB-4 index significantly improved 1 year after achieving SVR with direct-acting antivirals in both groups. CONCLUSION With optimal HIV/HCV treatment regimens, HCC occurrence and mortality risks in co-infected patients have become comparable to those in patients with HCV mono-infection.
Authors: Jeayeon Park, Jae Yoon Jeong, Soon Sun Kim, Jae Hyun Yoon, Hyuk Soo Eun, Jonggi Choi, Ki Tae Yoon, Young Kul Jung, Soo Young Park, Geum-Youn Gwak, Do Young Kim, Ji Hoon Kim, Jin-Woo Lee, Tae Yeob Kim, Jeong Won Jang, Su Jong Yu
Institutions: Seoul National University, Ewha Womans University Mokdong Hospital, Ajou University, Chonnam National University, Chonnam National University Hospital, Chungnam National University, Chungnam National University Hospital, Asan Medical Center, Pusan National University Yangsan Hospital, Korea University, Korea University Medical Center, Kyungpook National University Hospital, Kyungpook National University, Samsung Medical Center, Sungkyunkwan University, Yonsei University, Severance Hospital, Inha University, Inha University Hospital, Catholic University of Korea
Language: English
Topic: Hepatitis C virus research
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Awards: G2668593178, G2718735591
OpenAlex ID: W7124419745